LE T T E R T O T H E ED I T O R

A Local Health Department’sSchool-Located Vaccination ClinicsExperience With H1N1 PandemicInfluenza Vaccine

On June 11, 2009, theWorld Health Organization

signaled the novel H1N1 globalpandemic.1 The U.S. pandemicpreparedness and response plansindicate that the entire popula-tion should be vaccinated begin-ning with defined priority groupsincluding school-aged children.2

Data show direct beneficial effectsof the school-located vaccina-tion (SLV) campaigns.3,4 Therefore,the Kanawha-Charleston HealthDepartment (KCHD) planned tooffer H1N1 pandemic influenzavaccine to over 30,000 childrenenrolled in public and privateschools in the largest county inWest Virginia over a 5-week period.

KCHD initiated its SLV clinicson October 27th to target childrenin accordance with Centers forDisease Control and Prevention’s(CDC’s) guidelines.5 We partneredwith school nurses, county and cityparamedics, school-based healthcenter, and community volun-teers/parents to conduct up to 14different onsite clinics in schoolseach day and completed the firstround of vaccination on Decem-ber 1, 2009. The standard processinvolved sending a packet homeincluding a consent form based onCDC guidelines and templates. Par-ents were notified by automatedphone call the day package wassent, and the day before vaccina-tion. School nurses reviewed theforms for accuracy including med-ical screening. On clinic day, asyoung children prepared to be vac-cinated, staff would place name tagsand stickers and organize them into2 lines based on whether they werereceiving live or inactivated vac-cine. This increased efficiency sig-nificantly. KCHD nurses vaccinated

Table 1. Number of Students Receiving the H1N1 Vaccine in Kanawha County Schools

Total # ofVaccinations

SchoolEnrollment

% of Students ReceivingVaccination

Elementary 7789 13,818 56.37%Middle 3218 6699 48.04%High 2347 7779 30.17%Private schools 1190 2169 54.86%

Total 14,544 30,465 47.74%

all students as well as entered alldata. During clinics, those parentswho were either pregnant or whohad other young children were alsoinvited.

With the implementation ofthis program we were able toachieve acceptable vaccinationrates despite the limited and unpre-dictable vaccine supplies (Table 1).Those contemplating such clin-ics must consider the followingvital issues: organization includingplanning, staffing, clear and opencommunications with the commu-nity through media educationalcampaigns, school administration’ssupport and record keeping. Aclear delineation and delegation ofroles and responsibilities betweenvarious agencies participating isessential. Furthermore, mecha-nisms should be available to rapidlybut efficiently train volunteer staffas they join. We developed a train-ing disc for this purpose. This discis available for download at theNational Association of Countyand City Health Officials’ Web site(www.NACCHO.org/toolbox). Toavoid fatigue and exhaustion, ade-quate arrangements for nutritionand rest are also essential. Finally,from a sensitivity standpoint, it isimportant to be deliberate in mix-ing private and public schools aswell as city and county schools (forcombined health departments).

In conclusion, our early resultsdemonstrate that while challeng-ing, SLV clinics can be accom-plished successfully if appropriatelyplanned. However, close partner-ship between school nurses and

local public health officials is essen-tial to success.

Rahul Gupta, MD, MPHHealth Officer and Executive Director,

(Rahul.Gupta@wv.gov), Kanawha Charleston HealthDepartment, 108 Lee Street, East,

Charleston, WV 25301.

Brenda Isaac, RNLead School Nurse, (issacrn@aol.com),

Kanawha County Schools 200 Elizabeth St. Charleston,WV 25311.

Janet Briscoe, RNDirector, (Janet.M.Briscoe@wv.gov),

Epidemiology and Threat Preparedness, KanawhaCharleston Health Department,

108 Lee Street, East, Charleston, WV 25301.

Received on January 4, 2010Accepted on January 25, 2010

References

1. World Health Organization. Newinfluenza A (H1N1) virus: global epi-demiological situation, June 2009. WklyEpidemiol Rec. 2009;84:24-57.

2. Schwartz B, Wortley P. Mass vaccina-tion for annual and pandemic influenza.Curr Top Microbiol Immunol. 2006;304:131-52.

3. Rand CM, Szilagyi PG, Yoo BK, AuingerP, Albertin C, Coleman MS. Additionalvisit burden for universal influenza vac-cination of US school-aged children andadolescents. Arch Pediatr Adolesc Med.2008;162(11):1048-1055.

4. Grijalva CG, Zhu Y, Griffin MR. Evidenceof effectiveness from a large county-wide school-based influenza immuniza-tion campaign. Pediatrics. 2006;118(3):865-873.

5. Centers for Disease Control and Pre-vention (CDC). Use of Influenza A(H1N1) 2009 Monovalent Vaccine.Recommendations of the AdvisoryCommittee on Immunization Prac-tices (ACIP), 2009. MMWR RecommRep. 2009;58(RR-10):1-8. Avail-able at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr58e0821a1.htm.Accessed November 18, 2009.

Journal of School Health • July 2010, Vol. 80, No. 7 • © 2010, American School Health Association • 325