A school based influenza immunization program: Partnering for success in vulnerable neighborhoods

Background-A coalition of community and academic groups in a North Central Florida county collaborated in the planning and implementation of a school based influenza immunization program (SBIIP) for 2009/2010. The program objective was for 70% of the 19,402 preK-8th grade students to be immunized against seasonal influenza. Based on a 2006-2007 SBIIP, elementary schools A& B, located in predominantly African American, low socioeconomic neighborhoods, had influenza immunization rates below 10%. In 2009, the percentage of students qualifying for “Free and Reduced Meals” from School A was 90.65% and School B was 96.02%. Public health nursing students' assistance was requested in September 2009 because of the poor return of influenza immunization consent forms from both schools A&B. Description-Senior BSN students' involvement included a variety of population focused educational opportunities. Collaborating with program organizers, students strategized regarding methods to educate parents, staff and students about the benefits of seasonal influenza immunizations and to encourage the return of consent forms. Interventions included creating a system within each school to organize and screen returned forms, talking to parents in school parking lots and classrooms about the SBIIP, and giving brief presentations to students in classrooms. The consent form return rate for School A went from 27% to 70% in the week following the initial nursing student interventions. Lessons Learned-Not including students referred to their health care providers for inactivated influenza vaccine, 54% of School A's and 55.4% of School B's students received live attenuated influenza vaccine. These percentages were similar to those in schools located in higher socioeconomic neighborhoods. Many of the strategies devised by nursing students were replicated at schools throughout the county. Recommendations-The complexity of the school nurses' role and the challenge of adding the SBIIP to other required responsibilities showed the value for future SBIIPs of having assigned teams including student nurses for each school. Vaccine education based on the unique needs of each school community may help dispel myths related to influenza vaccines and encourage participation in immunization programs.