Schools offer an opportunity to deliver new vaccines to adolescents who may not receive them in their medical home. However, school budgets and health priorities are set at the local level; consequently resources devoted to health-related activities vary widely. Partnering with schools requires soliciting buy-in from stakeholders at district and school levels and providing added value to schools. With appropriate resources and partnerships, schools could carry out vaccination-related activities from educating students, parents, and communities to developing policies supporting vaccination, providing vaccines, or serving as the site at which partners administer vaccines. Activities will vary among schools, but every school has the potential to use some strategies that promote adolescent vaccination.W ITH 3 NEW vaccines for adolescents recommended since 2005, and more on the way, effective mechanisms for delivering adolescent vaccinations are increasingly important. Because school occupies a significant part of most adolescents' lives, the potential range of roles for schools in adolescent vaccination, from education and promotion to vaccine administration, deserves special attention. Schools must devote significant energy to complying with numerous mandatory accountability measures as they fulfill their primary educational purpose, but every school has the potential to promote adolescent vaccination. Including schools as partners in promoting adolescent vaccination will complement other efforts and offer considerable access to an often hard-to-reach group.The information presented in this article rests on 3 assumptions. First, schools are not intended to replace the medical home as the primary location for vaccination of adolescents. Instead, vaccination-related activities in schools can supplement care received in the medical home. Therefore, we have focused this report on information and solutions that can be implemented in the current policy environment rather than the significant changes that would be needed to make schools the primary avenue for delivery of routine adolescent vaccinations. Second, the extent to which any strategy is implemented will vary according to vaccine and school, although every school can undertake vaccination-related activities at some level. Third, variable resources and competing priorities must be taken into account when considering options for addressing vaccination in school health programs. Issues such as pregnancy, sexually transmitted diseases, drug and alcohol abuse, obesity, and violence will often take precedence. 1 Based on these assumptions, we explore the role of schools in strengthening the delivery of vaccinations to adolescents by reviewing the current scope of school health resources, the history of US experience with school-based vaccination, and potential barriers to vaccination activities in schools. Laws that require vaccination for school attendance, which are known to be highly effective, are covered elsewhere in this supplement. 2 We have drawn on www...

According to the 2008 recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, influenza vaccine should be administered on an annual basis to all children aged 6 months through 18 years. School-age children are more likely than any other age group to be infected with influenza, and young children are at high risk for hospitalization resulting from influenza-related complications. Given children's pivotal role in transmission of influenza to their schoolmates, household contacts, and members of their communities, it has been suggested that routinely vaccinating children against the disease might reduce the burden of disease in the US population as a whole. School-located vaccination clinics could go a long way toward improving the rates of pediatric influenza immunization and enhancing the pandemic preparedness of communities. School nurses are urged to consider ways in which they can help advocate for, plan, and/or implement school-located influenza vaccination clinics.

Immunization compliance can require time and resources not readily available to school nurses in urban schools. Furthermore, immunizations can be perceived as lower priority at the high school level. But communicable disease outbreaks, such as the one experienced across the United States with measles, highlight the important role of school nurses in compliance activities. Using a five-step process, a school nurse was able to update one urban high school’s database to more accurately reflect student measles vaccination compliance. An initial immunization database query indicated that 12% of approximately 2,000 enrolled students lacked even one measles-containing vaccine. A search through the state immunization registry and individual student educational folders revealed that 65% of these students actually had at least one measles vaccination. Remedies under consideration by the district in addressing this discrepancy are described. The remaining students (4% of total enrollment) required the additional steps of notification and intensive follow-up with students and their families. Within 2 months, fewer than 1% of students lacked a record of measles vaccination. The five steps presented can be adapted to achieve compliance with all required vaccines.

Objective: To evaluate hepatitis B virus (HBV) vaccine coverage and its associated factors among health science students in Vietnam. Methods: This cross-sectional study involving 459 health science students at Tra Vinh University was conducted between April and June 2022. Data were collected using a structured questionnaire with items on sociodemographic characteristics, knowledge and attitude about HBV, and vaccination status. A multivariable logistic regression model was used to explore the factors associated with vaccination status. Results: The majority of participants were female (65.8%) and enrolled at the medical school (56.2%). A total of 30.3% participants received the full dose of the HBV vaccine. The percentages of participants with sufficient knowledge and positive attitudes toward HBV infection were 75.2% and 43.4%, respectively. Vaccination was 11.8 times higher in sixth-year medical students than any healthcare student in their first-year [adjusted odds ratio (aOR) 11.8, 95% CI 3.1-45.1, P<0.001], and the coverage was also significant higher in those who had sufficient knowledge (aOR 2.0, 95% CI 1.1-3.9, P<0.05) and positive attitudes (aOR 3.0, 95% CI 1.9-4.8, P<0.05) than in their counterparts. Conclusions: The majority of students were not fully vaccinated against HBV, indicating they were vulnerable to the disease. Administrators and authorities should reinforce health education messages aimed at encouraging all students to get vaccinated with the HBV vaccine, enhance their awareness and knowledge of HBV, and improve attitudes toward HBV infection prevention.

This article describes the implementation of a multi-grade immunization mandate and general strategies that can facilitate implementation. The experience is that of an urban school district in implementing California Assembly Bill 354 (AB 354), which mandated pertussis vaccination for adolescents in 7th through 12th grades by the first day of school in 2011. AB 354 provided hardly a year's notice in obligating health departments to increase access to vaccinations and the school districts in collecting proof of vaccination of students enrolled in six sequential grade levels. Key strategies in achieving compliance with adolescent vaccination mandates include the following: creating a task force that facilitates open and regular communication within the school district and with counterparts at the health department; having, in leadership positions, a high-level school administrator and a school nurse; ensuring that exclusions are effectively publicized and implemented; assuring that the database system allows school staff to generate real-time reports to monitor progress; providing all families with easy and low-cost access to immunizations while focusing on students who might be more vulnerable; and using traditional and electronic media to publicize the new requirement.