title: School-Located Influenza Vaccinations: A Randomized Trial.
abstract: Assess impact of offering school-located influenza vaccination (SLIV) clinics using both Web-based and paper consent upon overall influenza vaccination rates among elementary school children.
  
  
  
  We conducted a cluster-randomized trial (stratified by suburban/urban districts) in upstate New York in 2014-2015. We randomized 44 elementary schools, selected similar pairs of schools within districts, and allocated schools to SLIV versus usual care (control). Parents of children at SLIV schools were sent information and vaccination consent forms via e-mail, backpack fliers, or both (depending on school preferences) regarding school vaccine clinics. Health department nurses conducted vaccine clinics and billed insurers. For all children registered at SLIV/control schools, we compared receipt of influenza vaccination anywhere (primary outcome).
  
  
  
  The 44 schools served 19 776 eligible children in 2014-2015. Children in SLIV schools had higher influenza vaccination rates than children in control schools county-wide (54.1% vs 47.4%, P < .001) and in suburban (61.9% vs 53.6%, P < .001) and urban schools (43.9% vs 39.2%; P < .001). Multivariate analyses (controlling for age, grade, vaccination in previous season) confirmed bivariate findings. Among parents who consented for SLIV, nearly half of those notified by backpack fliers and four-fifths of those notified by e-mail consented online. In suburban districts, SLIV did not substitute for primary care influenza vaccination. In urban schools, some substitution occurred.
  
  
  
  SLIV raised seasonal influenza vaccination rates county-wide and in both suburban and urban settings. SLIV did not substitute for primary care vaccinations in suburban settings where pediatricians often preorder influenza vaccine but did substitute somewhat in urban settings.
authors.affiliation: Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, California; pszilagyi@mednet.ucla.edu.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Szilagyi
authors.affiliation: Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and.
authors.forename: Stanley
authors.initials: S
authors.lastname: Schaffer
authors.affiliation: Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Rand
authors.affiliation: Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Vincelli
authors.affiliation: Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and.
authors.forename: Ashley
authors.initials: A
authors.lastname: Eagan
authors.affiliation: Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and.
authors.forename: Nicolas P N
authors.initials: NP
authors.lastname: Goldstein
authors.affiliation: Department of Clinical and Social Psychology, Children's Institute Rochester, University of Rochester, Rochester, New York.
authors.forename: A Dirk
authors.initials: AD
authors.lastname: Hightower
authors.affiliation: Department of Public Health, Monroe County, New York.
authors.forename: Mary
authors.initials: M
authors.lastname: Younge
authors.affiliation: Department of Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, and.
authors.forename: Aaron
authors.initials: A
authors.lastname: Blumkin
authors.affiliation: Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, California.
authors.forename: Christina S
authors.initials: CS
authors.lastname: Albertin
authors.affiliation: Department of Public Health Sciences, University of California at Davis, Davis, California; and.
authors.forename: Byung-Kwang
authors.initials: BK
authors.lastname: Yoo
authors.affiliation: Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri.
authors.forename: Sharon G
authors.initials: SG
authors.lastname: Humiston
mesh_terms: D002648:Child; D032962:Consent Forms; D034742:Electronic Mail; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D009518:New York; D016730:Program Development; D015397:Program Evaluation; D012424:Rural Population; D012572:School Health Services / Q000458:organization & administration*; D012574:Schools / Q000706:statistics & numerical data; D014505:Urban Population; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines