School-based health centers increase vaccination uptake
MedWire News: Study findings suggest that school-based health centers have the potential to achieve high rates of routine vaccinations, especially in adolescents.
These centers "can provide comprehensive care to children and adolescents who are hard to reach," said lead investigator Allison Kempe (University of Colorado Denver, Aurora, USA) in a press statement.
"I think it's a very important model especially in underserved and low income areas. School-based health centers are not prevalent across the United States but I think they should be," she added.
The researchers carried out a demonstration study (no control group) in 265 sixth grade girls (11-12 years) who needed at least one vaccination and a randomized controlled trial in a group of 264 similarly aged boys requiring immunizations. The study was carried out between October 2008 and March 2009.
As reported in Pediatrics, the demonstration study had promising findings resulting in 77% of the girls receiving at least one vaccination and 45% receiving all recommended vaccinations. The girls were not enrolled in a randomized controlled trial because of concerns that "such a study might compromise their opportunity to complete the human papillomavirus vaccine (HPV) series within the school year," say the authors.
The vaccinations in the demonstration study included combination tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine; quadrivalent meningococcal conjugate vaccine; and human papillomavirus vaccine.
Rates of uptake of the three vaccines among the girls were 68%, 57%, and 59%, respectively.
In the randomized controlled trial, half the boys were assigned to get reminders from their school-based health center to attend for vaccinations (pass sent to student in classroom, phone call to classroom, or walked to health center by member of staff) and half to usual care (no reminders, but immunization with consent form when visiting center for any reason).
The team found that 68% of the boys who received reminders had at least one vaccination and 59% received all the study vaccinations (combination tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine and quadrivalent meningococcal conjugate vaccine) compared with a respective 45% and 36% of the control group.
The researchers estimate that the cost of reminding students about vaccinations would be small, ranging from US$ 1.12 (€ 0.86) per child to a maximum of $ 6.87 (€ 5.28) per child in one school.
"These data reinforce the notion that school-based health centers are very valuable in providing health care to kids who are uninsured, come from poor backgrounds, or are adolescents," said Kempe.
"Our study shows how well these kinds of reminders work in school. They are effective, easy and cheap."
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By Helen Albert