title: Factors associated with uptake of the Influenza A(H1N1)pdm09 monovalent pandemic vaccine in K-12 Public Schools, Maine 2009-2010.
abstract: OBJECTIVE
  Maine implemented a statewide pre-K through 12-school vaccination program during the 2009-2010 H1N1 influenza pandemic. The main objective of this study was to determine which school, nurse, consent form, and clinic factors were associated with school-level vaccination rates for the first dose of the 2009 H1N1 pandemic vaccine.
  
  
  METHODS
  In April 2010, school nurses or contacts were e-mailed electronic surveys. Generalized linear mixed regression was used to predict adjusted vaccination rates using random effects to account for correlations within school districts. Elementary and secondary (middle and high) schools were analyzed separately.
  
  
  RESULTS
  Of 645 schools invited to participate, 82% (n = 531) completed the survey. After excluding schools that were ineligible or could not provide outcome data, data for 256 elementary and 124 secondary public schools were analyzed and included in the multivariable analyses. The overall, unadjusted, vaccination rate was 51% for elementary schools and 45% for secondary schools. Elementary schools that had 50 or fewer students per grade, had availability of additional nursing staff, which did not require parental presence at the H1N1 clinic or disseminated consent forms by mail and backpack (compared with backpack only) had statistically significant (P < .05) higher (adjusted) vaccination rates. For secondary schools, the vaccination rate for schools with the lowest proportion of students receiving subsidized lunch (ie, highest socioeconomic status) was 58% compared with 37% (P < .001) for schools with the highest proportion receiving subsidized lunch.
  
  
  CONCLUSIONS
  Several factors were independently associated with vaccination rates. For elementary schools, planners should consider strategies such as providing additional nursing staff and disseminating consent forms via multiple methods. The impact of additional factors, including communication approaches and parent and student attitudes, needs to be investigated, especially for secondary schools.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Lorick, Zhang, and Graitcer); Alameda County Public Health Department, Oakland, California (Ms Goldberg); Maine Department of Health and Human Services, Maine Center for Disease Control and Prevention, Augusta, Maine (Ms Birkhimer); Maine Department of Education, Augusta, Maine (Ms Dube); University of Arkansas at Pine Bluff, Pine Bluff, Arkansas (Ms Dutram); Molina Medicaid Solutions, Baton Rogue, Louisiana (Dr Hubley); Tipton Enterprizes Inc, South Portland, Maine (Dr Tipton); Los Angeles County Department of Public Health, Los Angeles, California (Dr Basurto-Davila); and University of New England, Portland, Maine (Dr Mills).
authors.forename: Suchita A
authors.initials: SA
authors.lastname: Lorick
authors.forename: Lisa
authors.initials: L
authors.lastname: Goldberg
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.forename: Nancy
authors.initials: N
authors.lastname: Birkhimer
authors.forename: Nancy
authors.initials: N
authors.lastname: Dube
authors.forename: Kay
authors.initials: K
authors.lastname: Dutram
authors.forename: Teresa
authors.initials: T
authors.lastname: Hubley
authors.forename: Meredith
authors.initials: M
authors.lastname: Tipton
authors.forename: Ricardo
authors.initials: R
authors.lastname: Basurto-Davila
authors.forename: Sam
authors.initials: S
authors.lastname: Graitcer
authors.forename: Dora Anne
authors.initials: DA
authors.lastname: Mills
mesh_terms: D000293:Adolescent; D002648:Child; D004196:Disease Outbreaks / Q000517:prevention & control; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control*; D008281:Maine; D012572:School Health Services / Q000706:statistics & numerical data / Q000639:trends*; D011795:Surveys and Questionnaires
chemical_list: D007252:Influenza Vaccines