School nurse change agents: Closing the gap for an under -immunized school population

Framingham Massachusetts Public Schools, with 8300 students, serves a culturally, ethnically, and economically diverse community. Framngham's families have multiple challenges including financial concerns, insecure employment, language barriers, immigration issues, lack of health insurance, transportation, and difficulty navigating the health care system. In the past, strategies to assure meeting immunization requirements included excluding a student from school if missing a vaccine. This strategy was challenging and only moderately effective and did not meet the education or health needs of the students. Our goal was to eliminate the excluding students for lack of an immunizations and mitigate barriers to timely and convenient access to immunizations for all students. The elimination of exclusions required a collaborative process with state and local agencies, pediatric health care providers, businesses and the media, all skills and strategies reinforced by the Summer School Health Leadership Institute. Descriptions of the challenges faced as well as the successes will be shared. The collaboration between school nurse leaders, public health agencies and community health champions brings about Enduring Change for communities.