A sustainability model for school-located influenza vaccine clinics: The dollars and “sense” of billing private insurers

Mass vaccination of school-aged children may be the most efficient approach in reducing population-level influenza illness attack rates and substantially reducing the overall morbidity and mortality associated with influenza-related illness in the community. For this to be achieved, requires the development of sustainable annual vaccination programs for children of all ages. Currently, with significant reductions in federal, state or local funding, most school-located influenza vaccine (SLIV) programs across the nation are having to overcome potential challenges including securing funding or a source of reimbursement to purchase vaccine and supplies, pay for staff, printing cost of information packets for parents, and other related expenses. Serving over 100 public and private schools with enrollment approximates of 30,000 students, the Kanawha-Charleston Health Department (Department) has developed a financially sustainable seasonal influenza vaccination program in schools by utilizing billing of third party payers including government and private insurers. Year 2012-13 marks the 4th consecutive year that the Department has held SLIV clinics for children in public and private schools grades K – 12. The Department has developed and implemented an immunization program that is not only completely self-sustaining, but also profitable. Since 2009, the Department has worked to improve the quality of the SLIV program and to build it into a model that other health departments can adopt. Finally, we discuss evaluation of the SLIV program by analyzing the four-year student absenteeism data compared to baseline rates which has demonstrated that higher influenza vaccination rates correlate with reduced absenteeism in schools.