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“Stop Flu at School” Implementing a Statewide School-located Influenza Vaccination Program. Hawaii Department of Health. Rationale for Developing Hawaii Stop Flu at School Program. Prevent childhood illness Indirectly decrease community transmission ACIP Recommendations
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“Stop Flu at School”Implementing a Statewide School-located Influenza Vaccination Program Hawaii Department of Health
Rationale for DevelopingHawaii Stop Flu at School Program • Prevent childhood illness • Indirectly decrease community transmission • ACIP Recommendations • Prepare for possible mass vaccinations of school children in the event of an influenza pandemic
Considerations for Implementation • Planning/Proposal • Collaborating Partners • Logistics • Budget/Expenditures • Media/Communications
2006-2007 Pilot Project • Feasibility of providing choice of TIV or LAIV • 3 elementary schools • Overall vaccination rate: 35%
Expansion toStatewide Influenza Immunization Program • Grades K – 8 • All Hawaii public and private schools invited to participate • Voluntary written consent of parent/guardian required • Offered TIV and LAIV • Two clinics held for schools with children aged less than 9 years in first year (2007-08); only 1 clinic in subsequent years
Program Goals • 95% participation rate for all public and private K-8 schools • 50% influenza vaccination uptake for Hawaii school children grades K-8 in participating schools
Collaborating Partners Formation of an Executive Advisory Committee Neighbor Island District Health Offices • Hawai`i Department of Education • Hawai`i Association of Independent Schools • Hawai`i Catholic Schools • Hawai`i Pacific University, School of Nursing • Kauai Community College, School of Nursing • Maui Community College, School of Nursing • University of Hawai`i at Manoa, School of Nursing • American Academy of Pediatrics – Hawai`i Chapter • American Academy of Family Physicians - Hawai`i Chapter • Hawai`i Medical Services Association • Hawai`i County Fire Department • Kaiser Foundation Health Plan • Kahu Malama • MedImmune, Inc. • Medical Reserve Corps – Oahu, Maui, Hawaii, and Kauai counties • Sanofi Pasteur • U.S. Military’s Joint Public Health Emergency Working Group • West Kauai Lions Club • Etc.
Logistics – Pre-planning • School, student, and vaccine projections • Staffing projections • IT support • Budget analysis • Timelines • Printed materials and communications Feasible?
Timeline – Overview Schools Asked Order Vaccines Schools Scheduled Consents Sent Consents Due/Review Staffing Arranged Promotion Clinics *2007-08 only
Consent Forms Separate (color-coded) consent forms for LAIV and TIV Subsequent years 2007-2008 (Printed in triplicate)
Estimated Expenditures* *Note that expenditure figures for 2009 still being finalized. †Medical Supplies, Print Materials, Data Entry, Staff, Curriculum & Training, Public Relations, Courier, Promotion & Incentives
Media/Communications • Develop Public Service Announcements (PSA) • TV commercials • Radio spots • Newspaper advertisements • Flyers • Morning show interviews (TV and radio) • Governor’s announcement • Call centers • Public inquiries • Physician inquiries and reporting of adverse events • Translation services • Coordinate media events at school clinics
Participation and Flu Vaccine Doses Adminstered through School-located Clinics,Hawaii 2007-2009 *Preliminary Data
Lessons Learned • Consent Form • Separate TIV and LAIV • Simplify • 2nd dose clinics for children under age 9 years • 45% of all clinics were 2nd dose clinics • Diminishing returns • Staffing • Student nurses • Medical Reserve Corp • Contract nurses
Advantages • Established relationships with partners • Existing forms and procedures • Existing supplies • Staffing sources • Parental/community support
Challenges • H1N1 clinics followed seasonal clinics, beginning November 2009 • Limited staff available to run additional clinics • Uncertainty regarding timing of availability of 2009 Influenza A H1N1 vaccine • Short lead-time • School furlough days
Summary • School-based influenza vaccination clinics are feasible • Provide infrastructure for pandemic preparation • Require extensive planning • Close collaboration with partners, especially schools • Funding – constant challenge • Once established, public expectation (and support) for clinics to continue • Assessment of impact
Thank You www.stopfluatschool.com