Expanding Access to Influenza Vaccine: Importance of School-Located Vaccination

Background: 

In 2009, the New York City (NYC) Department of Health and Mental Hygiene conducted a school-located vaccination (SLV) campaign to deliver 2009 influenza A (H1N1) monovalent vaccine (pH1N1) to children in elementary schools.  Children could also receive both pH1N1 vaccine and seasonal influenza vaccine through their medical provider.

Objectives: To determine the success of the SLV program in reaching children who were unlikely to be immunized otherwise and to compare characteristics of children vaccinated though SLV to children who received pH1N1 at a provider’s office.

Methods: 

Data on children who received pH1N1 were obtained from NYC’s Citywide Immunization Registry (CIR).  History of seasonal influenza vaccination, age, sex, mean number of immunizations, status of childhood immunizations, second dose completion rate, and Vaccines for Children (VFC) eligibility status were compared between children vaccinated in schools vs. those in a provider’s office.

Results: 

The SLV campaign vaccinated almost as many children as provider offices, 106,839 and 132,829, respectively.  Children vaccinated at schools were less likely to have received seasonal influenza vaccine in the past than children vaccinated at provider offices (65% vs. 90%, p<0.001). They were also less likely to have received seasonal vaccine in both the 2009-2010 season (31% vs. 75%) and 2008-2009 season (32% vs. 48%), less likely to be up-to-date on routine childhood immunizations (42% vs. 49%), more likely to have received a second dose of H1N1 (80% vs. 44%), and less likely to be VFC-eligible (66% vs. 77%).

Conclusions: 

SLV was successful in reaching a different subset of children who may not have been seen in a provider’s office. One-third of SLV children had never received influenza vaccine previously and nearly 70% had not received influenza vaccine in the 2009-2010 season. SLV should be considered as an important strategy for delivering seasonal influenza vaccine annually and promoting implementation of universal influenza vaccine recommendations.