Multicomponent Interventions to Enhance Influenza Vaccine Delivery to Adolescents

• Authors: Lisa M. Gargano, Emory University; Karen Pazol, Emory University; Jessica Sales, Emory University; Julia Ellenberg Painter, Emory University; Christopher Morfaw, Medical College of Georgia; LaDawna M. Jones, Emory University; Paul Weiss, Emory University; James W Buehler, Emory University; Dennis L. Murray, Medical College of Georgia; Gina M Wingood, Emory University; Walter Orenstein, Emory University; Ralph Joseph Diclemente, Emory University; James M Hughes, Emory University
• Journal Title: Pediatrics
• Volume: Volume 128, Number 5
• Publisher: American Academy of Pediatrics | 2011-11, Pages e1092-e1099
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1542/peds.2011-0453
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: influenza vaccine; school-based clinics; adolescents; pandemic preparedness

Abstract

OBJECTIVE: To compare school- versus provider-based approaches to improving influenza vaccination coverage among adolescents in rural Georgia. METHODS: We used a nonrandomized, 3-armed design: (1) a middle- and high school-based influenza vaccination intervention in 1 county; (2) a provider-based influenza vaccination intervention in a second county; and (3) a standard-of-care condition in a third county. Interventions also included distribution of an educational brochure, school presentations, and community-based outreach to enhance vaccine knowledge and awareness among adolescents and their parents. RESULTS: During the 2008–2009 influenza season, 70 (19%) of 370 students were vaccinated in the school-based county and 110 (15%) of 736 students were vaccinated in the provider-based county, compared with 71 (8%) of 889 students in the standard-of-care county (risk ratio [RR]school: 2.4 [95% confidence interval (CI): 1.7–3.2]; RRprovider: 1.9 [95% CI: 1.4–2.5]). During 2009–2010, seasonal influenza vaccination coverage was 114 (30.4%) of 375 of students in the school-based county, 122 (16.9%) of 663 of students in the provider-based county, and 131 (15.2%) of 861 students in the standard-of-care county (RRschool: 2.3 [95% CI: 1.9–2.9]; RRprovider: 1.2 [95% CI: 0.97–1.5]). CONCLUSIONS: Special efforts to promote influenza vaccination among rural, predominantly black students were associated with increased vaccination coverage. The school-based influenza vaccination intervention was associated with the highest levels of vaccination coverage. This study revealed the efficacy of school-based influenza education to improve vaccination rates among adolescents.