Immunization Resources

Despite years of effort, immunization rates have not reached desired levels in the United States. On-time vaccination throughout childhood is essential because it helps provide immunity before children are exposed to potentially life-threatening diseases. Vaccines are tested to ensure that they are safe and effective for children to receive at the recommended ages. According to Federal health data, New York is among the 10 states with the lowest vaccination rates. School-based health centers (SBHCs) improve adolescent vaccination rates, while simultaneously saving health care dollars for society. Below are resources for SBHCs and Parents/Caregivers to consider when vaccinating their children. 

Immunization Laws & Vaccination Schedules

New York State Recommended Vaccine Schedule​

CDC Recommended Vaccine Schedule

New York State Immunization Laws & Regulations

Resources for SBHC and Staff

Resources for Parents & Caregivers

Literature on SBHCs and Immunizations

For a full database on published literature related to School-based health centers and Immunizations visit the SBHC Literature Database built by the National School-Based Health Alliance. Below are some papers we believe highlight the important role of SBHCs in providing students with vital vaccines.

Efficacy of LAIV-T on Absentee Rates in a School-Based Health Center Sample

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Objective: To determine the effectiveness of the intranasal LAIV-T in decreasing school absenteeism in a school-based vaccination initiative and to compare the acceptability of LAIV-T versus TIV among adolescents.

Finding: LAIV-T was associated with a reduction in nonsuspension absences and was well
accepted by students. Administration of LAIV-T may be a convenient and effective method to
mass-immunize students in a school setting and help establish herd immunity within the community.

Process Evaluation of an Intervention to Increase Provision of Adolescent Vaccines at School Health Centers

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Objective: A process evaluation of an intervention to increase school-based health center-located vaccination to better understand the feasibility and challenges of such interventions among school-based health centers (SBHCs) in four traditional high schools in one district in central North Carolina.

Finding: This low-resource intervention successfully obtained consent for at least one vaccine from 10% of parents whose children were enrolled in an SBHC. Parents indicated the intervention materials were clear and persuasive and provided reminders about adolescent vaccination and information about the SBHC vaccination program. Most parents who consented opted to provide global consent, using the all recommended vaccine checkbox, rather than identifying specific vaccines. However, this study identified two topics that require more explanation in vaccination program material: vaccination costs and male HPV vaccination.

 

Addressing Adolescent Immunization Disparities: A Retrospective Analysis of School-Based Health Center Immunization Delivery

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Objective: A comparison of completion rates for adolescent immunization series administered at SBHCs to completion rates for series administered at CHCs within a single integrated delivery system among patients aged 12-18 years in Denver, Colorado.

Finding: In this analysis SBHCs were found to be superior to CHCs as a setting for completion of adolescent immunization series, even after adjusting for significant demographic differences. Children and adolescents seen in SBHCs were more likely to be up to date for hepatitis B, Tdap, varicella, measles/mumps/ rubella, HPV for patients aged 16 to 18 years, and the HPV/Tdap/MCV4 immunization series for female patients aged 16 to18 years. SBHC users were more likely to complete series that required multiple doses (hepatitis B, Tdap, varicella, and HPV), with the exception of hepatitis A. CHC users were more likely to be up to date for tetanus/diphtheria vaccinations. There were no differences by site of care for hepatitis A or MCV4 vaccinations.

Effectiveness and Cost of Immunization Recall at School-Based Health Centers

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Objective: Effectiveness of recall for immunizations has not been examined in the setting of school-based health centers (SBHCs). We assessed (1) immunization rates achieved with recall among sixth-grade girls (demonstration study); (2) effectiveness of recall among sixth-grade boys (randomized controlled trial [RCT]); and (3) cost of conducting recall in SBHCs.

Finding: At the end of the demonstration study, 77% of girls had received ≥1 vaccine and 45% had received all needed adolescent vaccines. Rates of receipt among those needing each of the vaccines were 68% (160/236) for tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, 57% (142/248) for quadrivalent meningococcal conjugate vaccine, and 59% (149/253) for the first human papillomavirus vaccine. At the end of the RCT, 66% of recalled boys had received ≥1 vaccine and 59% had received all study vaccines, compared with 45% and 36%, respectively, of the control group (P < .001). Cost of conducting recall ranged from $1.12 to $6.87 per recalled child immunized.

Improving HPV Vaccine Delivery at School-Based Health Centers

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Objective: To identify characteristics associated with human papillomavirus (HPV) vaccination rates, describe barriers and facilitators to vaccine uptake and the potential role for clinician-to-clinician Assessment, Feedback, Incentives, and eXchange (AFIX) visits in school-based health centers (SBHCs).


Finding: Baseline initiation and completion rates were 76% and 43% for high schools, and 81% and 45% for middle schools. SBHCs that allowed adolescent self-consent or did not require separate vaccine consent had higher baseline rates, but was not statistically significant. Barriers to series completion included challenges with scheduling and appointment compliance. At follow-up, high school SBHCs increased HPV vaccine initiation by 2.9 percentage points (p < 0.01) and series completion by 2.7 percentage points (p < 0.05). There was no statistically significant increase at middle school SBHCs. Most
SBHCs (88%) chose reminder/recall systems as a QI strategy. Fewer than half (42%) implemented their QI strategy.

 

Acceptability of School-Based Health Centers for Human Papillomavirus Vaccination Visits: A Mixed-Methods Study

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Objective: To study facilitators, barriers, and overall acceptability of HPV vaccination visits at SBHCs from the perspective of students and parents.

Finding: Parents who had used SBHCs previously were more willing to use an SBHC for HPV vaccinations than those who had not used an SBHC. Facilitators were convenience and ease of access, barriers were concerns about fragmented care and records and negative perceptions of SBHCs.