Physician-Sponsored Influenza Immunization in Schools

Monday, October 19, 2009: 11:45 AM
Farragut Square-Lafayette Park (Grand Hyatt)
Harry F. Hull, M.D., H.F. Hull and Associates, LLC, Saint Paul, MN

Purpose: Annual influenza immunization is now recommended for all children aged 6 months to 18 years.  Immunizing a high percentage of school-aged children through physicians’ offices and public clinics will be difficult.  School-located immunization programs (SIPs) may offer an efficient, less costly means to reach large numbers of school-aged children.  There have been reports of physician-led SIPs conducted independently from public health departments, but little is known about these programs.  This study documented the experience of physicians–led SIPs for the benefit of other physicians considering organizing SIPs.

Methods: Physicians who had conducted independent SIPs during 2005-07 were identified based on media reports and personal communications.  Eight of 10 identified physicians consented to a structured 30-minute interview.

Results: SIPs targeted 1-6 schools.  While most were smaller, private schools, 2 SIPs vaccinated in public schools. A quarter to a third of students were immunized.  All SIPs vaccinated school staff; half were open to family members.  Informational packets were sent home by schools to obtain advance permission. All SIPs required prepayment; none billed insurance.  All clinics were held at the schools with 6 of 8 SIPs vaccinating during school hours.  All SIPs offered intranasal influenza vaccine. One program offered inactivated vaccine to adults, another to adolescents.  Physicians played leadership roles in organizing SIPs, securing the commitment of school nurses and administrators. Office staff and school nurses jointly planned and conducted most clinics.  With one exception, physicians were able to recoup all costs associated with the SIP. Seven physicians continue to conduct annual SIPs.  One SIP was discontinued due to financial losses from inadequate planning. All physicians felt that SIPs provided a valuable service, protecting children against influenza, and found their experience personally rewarding, expressing a willingness to organize future SIPs.  

Conclusion: Physicians can play an important leadership role in organizing influenza immunization programs for school communities where health departments are unable to do so; these programs appear particularly feasible in private schools.  SIPs are a community service the participating physicians viewed as personally rewarding and in most instances became self-sustaining annual events. 

 Sponsored by MedImmune.