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Story from the Field


Name of Health Department/Agency: Cumberland Plateau Health District
State: VA
Date Added: 11/30/2009
Themes: Vaccine Planning and Administration
Issue Summary: Vaccine planning and admin:  Annual seasonal flu in-school clinics
Description of Issue(s): We have, for the last three years, been annually providing a school based seasonal flu vaccine opportunity, using base agency funding and without any specific funding for doing so, to ALL Pre-K-12 schools, public and private in our 4 counties. We believe nationally we in the PH community should be strongly advocating this posture for the provision of an in-school vaccination opportunity for our school children for seasonal flu annually for 2 key reasons: 1) Prevention/reduction of morbidity and mortality (and lost instructional time) in our child population as well as the populations they may transmit to, particularly parents (lost work time) and vulnerable grandparents (hospitalization and death).? 2) Preparedness; such a practice will pay dividends in future pandemics or other events where the logistics and comfort levels with providing in-school flu or other vaccinations/medications will be far more routine?for at least as long as flu shots remain annual.

We also need to develop ways to vaccinate those who are among the most vulnerable children in this population.? The sad truth is that for many children obtaining parental consent is a huge barrier, not for those parents who deliberate and decide against it?this is their prerogative, but for many parents, for reasons ranging from illiteracy, a lack health literacy/inability to understand what is being asked, inability to attend to this information due to work pressures, substance abuse or other factors that make them unable to return a form and/or difficult to reach.? These same children often have irregular medical care.? This is a health disparity and an inequity that disproportionally impacts poor urban and rural folks.? We need to look at opt-out solutions rather than opt-in.
Actions taken to address the issue(s): We piloted this program three years ago. We provide a choice of mist or injectable.? We provide opportunities for insured, uninsured/VFC and indigent.? We provide it free for eligibles, bill where we can properly do so and accept cash from those that prefer to pay directly and are not eligible for VFC (15$ cash this year).
Outcomes that resulted from actions taken: We have increased the percentage of the school population vaccinated in our rural area each year.? This year we did 51 schools and got 18% overall. Clinics are done with existing staff (total district staffing is 65 FTEs, program accomplished with the direct participation of about 1/3 -1/2 of that number). We believe our H1N1 uptake rates now running around 35% average(range 9-85%)would have been lower had we not had this program in place.

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