title: Measles prevention in adolescents: lessons learnt from implementing a high school catch-up vaccination programme in New South Wales, Australia, 2014-2015.
abstract: BACKGROUND
  In response to a significant increase of measles cases and a high percentage of unvaccinated adolescents in New South Wales, Australia, a measles high school catch-up vaccination programme was implemented between August and December 2014. This study aimed to explore the factors affecting school-based supplementary immunization activities (SIAs) and to inform future SIA and routine school-based vaccination programme implementation and service provision.
  
  
  METHODS
  Focus group analysis was conducted among public health unit (PHU) staff responsible for implementing the SIA catch-up programme. Key areas discussed were pre-programme planning, implementation, resources, consent materials, media activity and future directions for school vaccination programme delivery. Sessions were audio recorded, transcribed verbatim and reviewed. Thematic analysis was conducted to identify the major themes.
  
  
  RESULTS
  Two independent focus groups with 32 participants were conducted in January 2015. Barriers to the SIA implementation included lead time, consent processes, interagency collaboration, access to the targeted cohort and the impact of introducing a SIA to an already demanding curriculum and school programme immunization schedule. A positive PHU school coordinator rapport and experience of PHU staff facilitated the implementation. Consideration of different approaches for pre-clinic vaccination status checks, student involvement in the vaccination decision, online consent, workforce sharing between health districts and effective programme planning time were identified for improving future SIA implementation.
  
  
  CONCLUSIONS
  Although many barriers to school programme implementation have been identified in this study, with adequate resourcing and lead time, SIAs implemented via a routine school vaccination programme are an appropriate model to target adolescents.
authors.affiliation: Immunisation Unit, Health Protection New South Wales, Australia .
authors.forename: Sonya
authors.initials: S
authors.lastname: Nicholl
authors.affiliation: School of Public Health and Community Medicine, UNSW Australia, New South Wales, Australia .
authors.forename: Holly
authors.initials: H
authors.lastname: Seale
authors.affiliation: Communicable Diseases Branch, Health Protection New South Wales, Australia .
authors.forename: Vicky
authors.initials: V
authors.lastname: Sheppeard
authors.affiliation: Immunisation Unit, Health Protection New South Wales, Australia .
authors.forename: Sue
authors.initials: S
authors.lastname: Campbell-Lloyd
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D007115:Immunization Schedule; D008297:Male; D008457:Measles / Q000517:prevention & control*; D009517:New South Wales; D011634:Public Health; D012574:Schools; D014611:Vaccination / Q000379:methods*