School-located influenza vaccination with third-party billing: what do parents think?
OBJECTIVE
School-located influenza vaccination (SLIV) may be instrumental in achieving high vaccination rates among children. Sustainability of SLIV programs may require third-party billing. This study assessed, among parents of elementary school students, the attitudes about SLIV and billing at school, as well as factors associated with being supportive of SLIV.


METHODS
We conducted a survey (April 2010 to June 2010) of parents of 1000 randomly selected primarily low-income children at 20 elementary schools at which SLIV with billing had occurred.


RESULTS
Response rate was 70% (n = 699). Eighty-one percent agreed (61% strongly) they "would be okay" with SLIV for their child. Many agreed it was better to get vaccinated at their child's doctor's office because they could take care of other health issues (72%) and the doctor knows the child's medical history (65%). However, an equal percentage (47%) thought the best place for influenza vaccination was the child's doctor's office and the child's school. Twenty-five percent did not want to give health insurance information necessary for billing at school. Factors independently associated with strongly supporting SLIV included parental education of high school or less (relative risk 1.30; 95% confidence interval 1.09-1.58), Hispanic ethnicity (1.25; 1.08-1.45); believing the vaccine is efficacious (1.49; 1.23-1.84); and finding school delivery more convenient (2.37; 1.82-3.45). Having concerns about the safety of influenza vaccine (0.80; 0.72-0.88) and not wanting their child to be vaccinated without a parent (0.74; 0.64-0.83) were negatively associated.


CONCLUSIONS
The majority of parents were supportive of SLIV, although parental concerns about not being present for vaccination and about the safety and efficacy of the vaccine will need to be addressed.
Children's Outcomes Research Program, The Children's Hospital, Aurora, Colo; Department of Pediatrics, University of Colorado, Aurora, Colo. Electronic address: Allison.Kempe@childrenscolorado.org.
Allison
A
Kempe
Children's Outcomes Research Program, The Children's Hospital, Aurora, Colo; Institute for Health Research, Kaiser Permanente, Denver, Colo.
Matthew F
MF
Daley
Children's Outcomes Research Program, The Children's Hospital, Aurora, Colo.
Jennifer
J
Pyrzanowski
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Ga.
Tara M
TM
Vogt
Children's Outcomes Research Program, The Children's Hospital, Aurora, Colo.
Elizabeth J
EJ
Campagna
Children's Outcomes Research Program, The Children's Hospital, Aurora, Colo; Department of Family Medicine, University of Colorado, Aurora, Colo.
L Miriam
LM
Dickinson
Department of Pediatrics, University of Colorado, Aurora, Colo; Community Health Services, Denver Health, Denver, Colo.
Simon J
SJ
Hambidge
Department of Family Medicine, University of Colorado, Aurora, Colo; Denver Public Health, Denver Health, Denver, Colo.
Judith C
JC
Shlay
D000328:Adult; D001294:Attitude to Health; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control*; D007349:Insurance, Health, Reimbursement; D008297:Male; D033282:Parental Consent; D010290:Parents; D012572:School Health Services
D007252:Influenza Vaccines
immunization delivery; influenza vaccination; school-located immunization delivery