Elementary and middle schools collaborate with public health to evaluate vaccination and absenteeism

Two state organizations in Maine worked with the Centers for Disease Control and Prevention (CDC) to evaluate the effects of 2009 pandemic influenza A (H1N1) monovalent (2009 H1N1) vaccination on elementary and middle-school student absenteeism during the fall and winter months of 2009.

The Maine Center for Disease Control and Prevention (Maine CDC), the state public health agency, chose school-located immunization clinics as its primary approach to distributing 2009 H1N1 vaccine in the state. The state's focus on school-located clinics allowed Maine CDC and the Maine Department of Education (Maine DoE) to evaluate the impact of 2009 H1N1 vaccination on student absenteeism. Evaluation efforts involved not only multiple state-level organizations, but also extensive partnerships between school departments, such as information technology (IT), human resources, and school nurses. Although results are not yet available, the evaluative process demonstrated the involvement of myriad school departments and commitment of personnel to a public health effort.

In spring 2010, Maine CDC and Maine DoE issued a mid-course evaluation proposal and request to several school superintendents. Elementary and middle schools in Androscoggin, Cumberland, Penobscot, and York counties received materials to evaluate student and staff absenteeism and 2009 H1N1 vaccination between October 5 and December 18, 2009.

Maine CDC and DoE ensured that the entire evaluation process followed regulations set forth by the Family Educational Rights and Privacy Act, so students' names and all identifying information were deleted before data were sent to CDC. Information on absenteeism and vaccination were also included in two separate charts filled out by different divisions within each school district, and the two variables were only analyzed together at a later time.

The evaluation consisted of three parts and relied on data collection by IT coordinators, school nurses, and school human resources personnel. Maine CDC provided reimbursement based on student enrollment to participating schools. Funding and reimbursement was intended to compensate staff for data-gathering activities outside of normal working hours or to hire staff if additional assistance was needed with compiling vaccination records.

IT coordinators handled the first step of collecting student absenteeism information, which included setting up a chart to hold absenteeism and additional data. IT staff also generated a district master list of students, student IDs, and student absenteeism data for each day during the evaluation period. IT coordinators could obtain the data via the schools' web-based reporting systems or they could use templates provided by Maine DoE.

District IT staff then sent the list containing absentee data, including de-identified information on students' grade, age, gender, primary language spoken, and race/ethnicity, directly to Maine CDC. IT coordinators also created a second list of student names, student IDs, and blank columns ready for school nurses to populate with student vaccination data.

School nurses gathered student vaccination data from each of the 93 participating schools. Specific information included the date when students received their first and/or second 2009 H1N1 vaccine, the type of vaccine each child received, and whether a student had consent to be vaccinated but did not receive a vaccine. The last step in the data collection process involved human resources personnel extracting missing teacher and staff absentee data from a school-based reporting system or via a template provided by Maine DoE.

Partnerships between two state organizations and engagement of different staff groups within Maine elementary and middle schools led to a collaborative evaluation process. Key partners within schools and their ability to obtain information from three different internal reporting systems allowed data gathering to be streamlined, confidential, and within school personnel's areas of expertise.

Evaluation of absenteeism and 2009 H1N1 vaccination in schools relied on a connected web of people who were able to use available resources and develop new relationships. Not only did Maine CDC and DoE create connections with schools based on provision of health guidance and support, but schools developed leadership and evaluation skills that may allow them to sustain public health response activities.

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