Routine Childhood Vaccines and Immunizations

The COVID-19 pandemic put our children’s lives at risk in unexpected ways. The Centers for Medicare and Medicaid Services (CMS) notes significant declines in childhood vaccinations. As vaccination rates fall behind, the risk for illness rises. Public vaccination rates fall behind private administration uptake, demonstrating significant inequality between private and publicly insured. School-based health centers (SBHCs) and other school-based health care programs serve some of the most vulnerable patients, reducing barriers such as cost and lack of insurance. By administering vaccinations to adolescents, school-based health care can further increase access to care, particularly for adolescents from families most in need. Too many children experience persistent disparities in health care access, quality, and outcomes.

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School-Based Covid-19 Vaccination

Essential to school-aged children and the health of our nation is administering adolescent COVID-19 vaccines– and soon to come–vaccinations for all ages. Vaccinating adolescents is a national priority, and school-based health care plays a critical role in this goal.

Resources for administering adolescent COVID-19 vaccines at schools:

Examples and Resources from the SBHC Field

As part of SBHA’s continued vaccine efforts to support and lift up the vaccine administration work of school-based health care. We continuously collect resources from the field. Do you have strategies to advance child and adolescent vaccinations and resources to share? If so, e-mail them to info@sbh4all.org for consideration. The following are examples and resources already shared by your peers that you can adapt. Please give the resource developers credit, “e.g., Adapted from Nationwide Children’s Hospital, Ohio.”

Adolescent COVID-19 Vaccination Program in Partnership with Schools

With the approval and rollout of COVID-19 vaccines for adolescents 12 and older, community health centers strategically partnered with schools to get students vaccinated. The School-Based Health Alliance interviewed four community health centers about their innovations and promising practices to promote, educate about, and implement adolescent COVID-19 vaccination clinics in partnerships with schools. Each health system worked closely with the school district to conduct the vaccination clinics on school property or provide transportation to sites in the Spring of 2021. Pressed to meet the needs of this public health emergency and the school year timeline, these partnering health centers in Oregon, Indiana, and New Hampshire moved quickly to ramp up their staffing, collect parental/guardian consents, conduct school site visits, educate families, and administer the vaccine before the summer break. The School-Based Health Alliance presents the case studies for inspiring promising practices for school-based COVID-19 vaccine clinics in a K-12 setting: Mosaic Medical, HealthLinc Community Health Center, Coos County Family Health Services, and St. John’s Well Child and Family Center. The need to build these relationships between schools and community health centers continues to grow as the country prepares for the imminent release of the vaccine for students ages 5-12.

Resources from school-based healthcare field:

Ideas you can try

School and Community Partnership

General Promotion:

  • Collaborate with schools on joint vaccine and communication efforts. The school is often a trusted resource, particularly for the most vulnerable families. Joint vaccine events with schools can increase adolescents’ and parents/guardians’ comfort level and trust. Schools and school districts communicate with their entire communities daily.
  • School districts promote the SBHC and immunization opportunities through existing communications.
  • Partner with community leaders, athletic coaches, and school staff that students look up to who can serve as models for vaccine acceptance and support outreach and marketing efforts.
  • Host virtual learning events for parents/guardians around or collaborate with existing community gatherings for town halls and discussions.

Identification of Students for Targeted Outreach:

  • Collaborate with school partners (school nurses, coaches, or administrators), health departments, and accountable care organizations or insurers to identify children due for routine childhood immunizations or well-child visits through school records, state-wide immunization databases, or claims data.

Delivery and Administration:

  • Partner with a local hospital, health department, or community pharmacy to provide vaccines and schools to provide space and resource support for vaccination clinics.
  • Consider non-traditional partners such as EMS to monitor for reactions or behavioral health to use the time before and after vaccination to screen for needs.
  • Fundraise from local businesses for food/drinks for vaccine clinic staff and incentives for students.

Communications

Content and Ease of Access:

  • Successful vaccine efforts at schools require culturally appropriate communication and trust between stakeholders (adolescents, parents/guardians, and school staff).
  • Buy-in and support ensure successful reach and trust-building with families.
  • Marketing that reflects the population of interest.
  • QR links for self-scheduling.

Online Platforms and Opportunities:

  • Make all information available online, including Vaccine Information Safety statements.
  • School webpage, newsletters, parent portals.
  • Emails, texts, phone calls, letters to parents/guardians.
  • Flyers in USDA Food Service program summer meal pickup bags for students.
  • Flyers posted in community.

Operations and Implementation

  • Clinics:
    • Curbside or parking lot based.
    • Gymnasium, cafeteria, auditorium, or other space in school including SBHC or school nurse space depending on the scale of initiative.
    • Mobile units to hold vaccine clinics, physicals, dental treatment, behavioral health, vision screenings, and health education.
  • Offer vaccine visits to all siblings in a family group when scheduling an appointment.
  • Screen for interest in COVID vaccine at all types of appointments.
  • Have same-day appointments available for students due for immunizations.
  • Use sports physicals and well-child visits as an opportunity to update needed immunizations.
  • Use time before and after vaccination to screen for social determinants of health, risk assessments, depression, other vaccine needs, and last well-child visit. Consider partners who can serve in this staffing role.
  • Offer enabling services at appointment through healthcare organization or community partner organization—such as enrollment in medical insurance, transportation, housing assistance.
  • Behavioral health staff take students to vaccination area and offer an opportunity to share their fears or anxieties about the vaccination. Demonstrate calming techniques to decrease anxiety.
  • Provide snacks, play music, allow a friend to accompany the student.
  • Ensure staff who first greet the students set the right tone.

Collaborating with Youth

  • Identify and train youth social media ambassadors and peer educators.
  • Develop communications messages and resources with and for adolescents; adolescents trust their peers and influence their parents’/guardians’ decisions.

Parent/Guardian Consents

  • Explore opportunities to accept witnessed phone consents from parents/guardians so that providers can administer vaccines at the same visit.
  • Translate consents to common languages.
  • Make forms available online so that parents/guardians can quickly fill out consents, even from their cell phones.

Miscellaneous Resources