Statewide school-located influenza vaccination program for children 5-13 years of age, Hawaii, USA

Abstract

New guidance recommends annual influenza vaccination for all children 5-18 years of age in the United States. During 2007-2008, Hawaii offered inactivated and live attenuated influenza vaccine at school-located clinics for grades kindergarten through 8. Most (90%) public and private schools participated, and 622 clinics were conducted at 340 schools. Of 132,775 children 5-13 years of age, 60,760 (46%) were vaccinated. The proportion vaccinated peaked at 54% for those 6 years of age and declined for older cohorts. More than 90% of schoolchildren transited the clinic in <10 minutes. A total of 16,920 staff-hours were expended; estimated cost per dose administered was $27 and included vaccine purchase and administration, health staffing resources, printing costs, data management, and promotion. This program demonstrates the feasibility of conducting mass school-located influenza vaccination programs in public and private schools statewide, as might be indicated to respond to pandemic influenza.

Figure 1

Number and proportion of children 5–13 years of age receiving >1 doses of influenza vaccine at school-located clinics, by county, Hawaii, USA, 2007–08 influenza season. Numerator is the number of children 5–13 years of age vaccinated in the program; denominator is the county population of children 5–13 years of age as of July 1, 2007.

Figure 2

Number and percentage of children 5–13 years of age receiving at least 1 dose of influenza vaccine through a school-located clinic, by year of age, Hawaii, USA, 2007–08 influenza season. White bars indicate number of children vaccinated; black line indicates percentage of children vaccinated.

Figure 3

Vaccination rate ranking, by school (grades K–8), public and private schools, Hawaii, USA, 2007–08 influenza season. Black line indicates public schools ranked 1–208 (left to right); gray line indicates private schools ranked 1–83 (left to right). Vertical line indicates the median.

Figure 4

Proportion of children enrolled in grades K–8 at each school who received at least 1 dose of influenza vaccine, by school size, Hawaii, USA, 2007–08 influenza season. Linear fit trend (gray line) calculated by using Excel software (Microsoft, Redmond, WA, USA); r = –0.05.

Figure 5

Proportion of children receiving at least 1 dose of influenza vaccine in school-located clinics, by age and vaccine formulation selected, Hawaii, USA, 2007–08 influenza season. LAIV, live attenuated influenza vaccine; TIV, trivalent Influenza vaccine; Either, parent or guardian consented to administration of either vaccine formulation to their child. N = 60,694; excludes 66 children for whom vaccine formulation data were not available.