|Challenges/Barriers: The biggest challenge was giving two vaccines at the same time and keeping everything straight, which required keeping everything separate, having it all on one consent form, and printing and distributing consent forms for some 500,000 students from the central supply area out to the field.
Another challenge was managing the media in the clinics. They would show up unannounced and of course want to interview someone.
The other issue was there wasn't enough vaccine for everybody so we did prioritize, which we knew would be a problem. We said wanted to start with the youngest kids in the school and work up through the grades, with the staff last. Of course, this caused some problems because staff often wanted their vaccines first.
Another barrier was that large schools decided often to have regional clinics. A school district would have 7-8 schools in their district and they would hold one clinic in which everyone was invited and it really turned into mass flu clinic situation with all the problems that go into that.
Some schools decided they didn't want to give live vaccine on campus and we were successful in talking them into it in most of the situations. Even those places where we were successful, we had some lawsuits threatened and some physical threats. Some of the nurses reported parents showing up at the health unit, in one case one was with a gun.
Another big issue was volunteers. We had a lot of volunteers and keeping them trained as they came and went. We did pre-clinic training, but a lot of them didn't show up. Those that did show up in time were actually given the vaccine. Keeping up with paperwork, such as getting copies of nursing licenses, was sometimes a real problem.
Lessons Learned: We did learn that the school nurse is our best friend because she knows lots of volunteers and was our best help in getting some good qualified volunteers. We learned that we need to work closely with the principals and other administrators because they can resolve a lot of issues before they become problems.
We learned that next time we do this we're not going to let individual schools make some poor decisions. We're going to insist that forms go home to students and returned in time so we can plan to have enough vaccine, forms, and volunteers there. Several schools decided to tell the parents in a newsletter just to show up and that was a real issue.
We learned that we need to assign one person whose only job is to coordinate the clinic. If that person tries to give vaccine and coordinate the clinic, answer questions, solve problems, it doesn't work. If you have a larger school, you may need a second person designated just to route patients and parents from administration tables to vaccination tables and to exit tables.
We learned that we need to double check all the permission forms for which vaccine the parent wants their child to have and just because a line has something written on it, it may not be a signature. You have to read carefully what is written in the signature line. We learned to read the health history and previous vaccines carefully and to watch our product that we're using and the lot number that goes with it. Sometimes that changed in the middle of the clinic.
We learned to identify staff and volunteers with name tags and t-shirts. We learned to train all our volunteers on patient flow and all the issues that go with the different vaccines.