title: A School-Located Vaccination Adolescent Pilot Initiative in Chicago: Lessons Learned.
abstract: BACKGROUND
  Many adolescents underutilize preventive services and are underimmunized.
  
  
  METHODS
  To promote medical homes and increase immunization rates, we conceptualized and implemented a 3-year, 8-school pilot school-located vaccination collaborative program. We sought community, parent, and school nurse input the year prior to implementation. We selected schools with predominantly Medicaid-enrolled or Medicaid-eligible students to receive Vaccines For Children stock vaccines. Nurses employed by a mass immunizer delivered these vaccines at participating schools 3 times a year.
  
  
  RESULTS
  Over 3 years, we delivered approximately 1800 vaccines at schools. School administrators, health centers, and neighboring private physicians generally welcomed the program. Parents did not express overt concerns about school-located vaccination. School nurses were not able to participate because of multiple school assignments. Obtaining parental consent via backpack mail was an inefficient process, and classroom incentives did not increase consent form return rate. The influenza vaccine had the most prolific uptake. The optimal time for administering vaccines was during regular school hours.
  
  
  CONCLUSIONS
  Although school-located vaccination for adolescents is feasible, this is a paradigm shift for community members and thus accompanies challenges in implementation. High principal or school personnel turnover led to a consequent lack of institutional memory. It was difficult to communicate directly with parents. Because we were uncertain about the proportion of parents who received consent forms, we are exploring Internet-based and back-to-school registration options for making the consent form distribution and return process more rigorous. Securing an immunization champion at each school helped the immunization processes. Identifying a financially sustainable school-located vaccination model is critical for national expansion of school-located vaccination.
authors.affiliation: Department of Pediatrics, University of Illinois at Chicago;
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Caskey
authors.affiliation: Department of Pediatrics, University of Chicago everly.macario@gmail.com.
authors.forename: Everly
authors.initials: E
authors.lastname: Macario
authors.affiliation: Department of Pediatrics, University of Chicago.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Johnson
authors.affiliation: Department of Pediatrics, University of Chicago.
authors.forename: Tamara
authors.initials: T
authors.lastname: Hamlish
authors.affiliation: Department of Pediatrics, University of Chicago.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Alexander
keywords: Adolescents; Medical Home; School-Located Vaccination