School vaccination campaign

South Carolina was able to quickly and efficiently implement school-based H1N1 influenza vaccination clinics in large school districts. The S.C. Department of Health and Environmental Control (DHEC) is organized geographically into eight public health regions. What follows are two examples that describe some of the successes and best practice strategies developed during this response in two of these regions.

Greenville County Schools:
Greenville County, located within DHEC region 2, contains the largest school district in South Carolina, serving almost 70,000 students. A total of 54 elementary schools span the county's 800 square miles. Recognizing that the organization of school-based H1N1 vaccination clinics in such a vast area would require an extraordinary planning effort, DHEC quickly initiated a strategy meeting including its staff and school district leadership.

In the face of so many unknowns, school district personnel elected to survey parents on their preferred times and locations for school-based clinics. Survey results indicated a preference for after-hours clinics. Based on survey responses, school district personnel also decided on a strategy to cluster schools. The county was divided into five geographic clusters. One school in each cluster hosted the vaccination clinic for all of the students who attended a school within that cluster.

Five evening vaccination clinics took place. Staffing for these after-hours weekday clinics did present a challenge. In collaboration with DHEC personnel, school district officials recruited their nursing staff for orientation, training and to work as vaccinators for DHEC. Additional school personnel assumed various roles in the clinic planning and execution effort to ensure organization, safety and security.

Richland School District 2:
Richland School District 2, in DHEC Region 3, is located in Columbia, which is the state capital and largest metropolitan area in South Carolina. This district employed a similar detailed planning initiative for its school-based vaccination clinics. The Richland County Health supervisor met with a Richland School District 2 administrator at the start of the school year to make plans for offering H1N1 immunizations to students. School district leaders worked with district nurses to develop an implementation plan for rolling out H1N1 vaccine once it became available. School nurses were assigned to mobile teams that would go into district schools and provide immunizations under the direction of a DHEC nurse.

DHEC created a parent packet, which included a cover letter from the agency's deputy commissioner for health services, a parental consent form and the Vaccine Information Statement. The cover letter notified parents that the H1N1 vaccine would be offered in their child's school, discussed safety of the vaccine, introduced the parental consent form and pointed parents to further resources through DHEC's Web site and the agency's Immunization and Flu Hotline (1-800-27-SHOTS). The agency's regular Immunization Hotline number was used, hours were expanded, an H1N1-focused script was developed, and staff from the Bureau of Maternal and Child Health's Care Line took calls from parents and the general public through this number. DHEC nurse consultants also were on call to answer detailed medical questions posed via the hotline.

The parent packets were sent to school districts across South Carolina, including Greenville and Richland 2. In Richland School District 2, school principals sent letters to parents, which were included with the DHEC packets. The district also sent out an automatic-dial phone messages to parents to notify them of the first doses. Some individual schools also sent out follow-up automatic-dial telephone messages as another reminder to parents. Information about the H1N1 efforts was posted on the school district website, as well.

The results of this initiative were better than expected. In Greenville County Schools, 8,312 school students and staff were immunized during these five clinics. Additional school-based clinics were scheduled to offer vaccine to more Greenville County School students. Due to the increased level of school district involvement and planning in Richland School District 2, DHEC staff was able to immunize 11,050 students and staff in the Richland County School District in just 13 days. A total of 11,777 doses of H1N1 vaccine were given in Richland School District 2 as of January 11th, 2010. Second doses for students less than 10 years of age were to conclude on Tuesday, Jan. 19, 2010.

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