Mass distribution of free, intranasally administered influenza vaccine in a public school system

OBJECTIVE. School-based influenza vaccination programs are a potentially important method of protecting the community against influenza. We evaluated the feasibility and success of a large, school-based influenza vaccination campaign. METHODS. On-site administration of intranasally administered, live attenuated influenza vaccine was offered to all students and staff members in a large, metropolitan public school system in October to December 2005. We evaluated vaccine coverage levels, resources expended, and physician and parent attitudes and knowledge. RESULTS. Of 53 420 public school students, 24 198 were vaccinated with live attenuated influenza vaccine. Of 5841 school staff members, 3626 were vaccinated with live attenuated influenza vaccine or inactivated influenza vaccine. The proportions of students vaccinated were 56% among elementary schools, 45% among middle schools, and 30% among high schools. Schools with larger proportions of black or low-income families had lower vaccine coverage levels. The health department and school system expended 6900 person-hours during the campaign, and various health department clinics were closed for a total of 84 half-days. Community physicians were supportive of the campaign and frequently advised participation for eligible patients. Some physicians had misunderstandings about live attenuated influenza vaccine contraindications. Concern about adverse effects, having asthma, negative physician advice, and nonparticipation in any vaccination program were common reasons for students not participating. CONCLUSIONS. This influenza vaccination campaign in a large public school system achieved relatively high vaccine coverage levels but required a substantial resource commitment from the local health department. This evaluation has critical implications for the ongoing debate regarding immunization policies for school-aged children and preparedness plans for pandemic influenza.