Obtaining Parental Consent In An Elementary School-Located Influenza Vaccination Program:Year 2

Background: This elementary school-located influenza vaccination (SLV) program featured a private vaccination vendor.  In Year 1 a low proportion of students returned completed consent forms and approximately 30% were incomplete.  Consent forms missing key elements further reduce the proportion of children who can be vaccinated in school and increase the personnel time needed to contact parents.

Objectives: Compare rates of parental consent and consent completion between Year 1 (2009-10) and Year 2 (2010-11)

Methods: Each year, intervention schools performed SLV during school hours, and both injected and nasal spray seasonal influenza vaccines were offered.  In Year 2 four main changes occurred: (1) extra schools in one district were recruited to replace those from another that did not want to participate again, (2) consent forms were simplified and were available in Spanish, (3) autodialer messages were added to parent notification, and (4) H1N1 was not making news in Year 2.  Parent notification included consent packets sent home in backpacks and (for some) following parent-teacher conferences plus automated calls before consents were due and before Vaccine Day.  Consent completion was categorized as Complete, Usable (solely missing an element that would not prohibit vaccination, e.g., mother’s maiden name), Unusable (missing an element that would prohibit vaccination, e.g., parent signature, billing or allergy information).

Results: In Year 2, 12 urban schools (5,061 students) and 9 suburban schools (4,527 students) participated. Overall consent returns for Years 1 and 2 were, respectively:  Urban--22%, 17.5%; Suburban--21%, 19%.  In Year 2, among returned consent forms (prior to staff efforts to contact parents for missing information) the proportion Complete, Usable, or Unusable were: Urban--52.3%, 37.0%, 10.7%; Suburban–79.7%, 18.9%, 1.4%.

Conclusions: The consent process for SLV is resource intensive and remains a challenge. New approaches to enhance completion of consent are needed in order to maximize opportunities to provide SLV when parents are not present.