School-located Influenza Vaccinations for Adolescents: A Randomized Controlled Trial

Peter G. Szilagyi, Stanley Schaffer, Cynthia M. Rand, Nicolas P.N. Goldstein, Phyllis Vincelli, A. Dirk Hightower, Mary Younge, Ashley Eagan, Aaron Blumkin, Christina S. Albertin, Kristine DiBitetto, Byung Kwang Yoo, Sharon G. Humiston

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Abstract

Purpose: We aimed to evaluate the effect of school-located influenza vaccination (SLIV) on adolescents' influenza vaccination rates. Methods: In 2015-2016, we performed a cluster-randomized trial of adolescent SLIV in middle/high schools. We selected 10 pairs of schools (identical grades within pairs) and randomly allocated schools within pairs to SLIV or usual care control. At eight suburban SLIV schools, we sent parents e-mail notifications about upcoming SLIV clinics and promoted online immunization consent. At two urban SLIV schools, we sent parents (via student backpack fliers) paper immunization consent forms and information about SLIV. E-mails were unavailable at these schools. Local health department nurses administered nasal or injectable influenza vaccine at dedicated SLIV clinics and billed insurers. We compared influenza vaccination rates at SLIV versus control schools using school directories to identify the student sample in each school. We used the state immunization registry to determine receipt of influenza vaccination. Results: The final sample comprised 17,650 students enrolled in the 20 schools. Adolescents at suburban SLIV schools had higher overall influenza vaccination rates than did adolescents at control schools (51% vs. 46%, p < .001; adjusted odds ratio = 1.27, 95% confidence interval 1.18-1.38, controlling for vaccination during the prior two seasons). No effect of SLIV was noted among urbanschools on multivariate analysis. SLIV did not substitute for vaccinations in primary care or other settings; in suburban settings, SLIV was associated with increased vaccinations in primary care or other settings (adjusted odds ratio = 1.10, 95% confidence interval 1.02-1.19). Conclusions: SLIV in this community increased influenza vaccination rates among adolescents attending suburban schools.

Original languageEnglish (US)
JournalJournal of Adolescent Health
DOIs
StateAccepted/In press - Jan 1 2017

Fingerprint

Human Influenza
Vaccination
Randomized Controlled Trials
Immunization
Students
Primary Health Care
Parents
Odds Ratio
Confidence Intervals
Consent Forms
Directories

Keywords

  • Adolescents
  • High school
  • Immunization rates
  • Influenza
  • Influenza vaccinations
  • Middle school
  • School health

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

Cite this

Szilagyi, P. G., Schaffer, S., Rand, C. M., Goldstein, N. P. N., Vincelli, P., Hightower, A. D., ... Humiston, S. G. (Accepted/In press). School-located Influenza Vaccinations for Adolescents: A Randomized Controlled Trial. Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2017.09.021

School-located Influenza Vaccinations for Adolescents : A Randomized Controlled Trial. / Szilagyi, Peter G.; Schaffer, Stanley; Rand, Cynthia M.; Goldstein, Nicolas P.N.; Vincelli, Phyllis; Hightower, A. Dirk; Younge, Mary; Eagan, Ashley; Blumkin, Aaron; Albertin, Christina S.; DiBitetto, Kristine; Yoo, Byung Kwang; Humiston, Sharon G.

In: Journal of Adolescent Health, 01.01.2017.

Research output: Contribution to journalArticle

Szilagyi, PG, Schaffer, S, Rand, CM, Goldstein, NPN, Vincelli, P, Hightower, AD, Younge, M, Eagan, A, Blumkin, A, Albertin, CS, DiBitetto, K, Yoo, BK & Humiston, SG 2017, 'School-located Influenza Vaccinations for Adolescents: A Randomized Controlled Trial', Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2017.09.021
Szilagyi, Peter G. ; Schaffer, Stanley ; Rand, Cynthia M. ; Goldstein, Nicolas P.N. ; Vincelli, Phyllis ; Hightower, A. Dirk ; Younge, Mary ; Eagan, Ashley ; Blumkin, Aaron ; Albertin, Christina S. ; DiBitetto, Kristine ; Yoo, Byung Kwang ; Humiston, Sharon G. / School-located Influenza Vaccinations for Adolescents : A Randomized Controlled Trial. In: Journal of Adolescent Health. 2017.
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abstract = "Purpose: We aimed to evaluate the effect of school-located influenza vaccination (SLIV) on adolescents' influenza vaccination rates. Methods: In 2015-2016, we performed a cluster-randomized trial of adolescent SLIV in middle/high schools. We selected 10 pairs of schools (identical grades within pairs) and randomly allocated schools within pairs to SLIV or usual care control. At eight suburban SLIV schools, we sent parents e-mail notifications about upcoming SLIV clinics and promoted online immunization consent. At two urban SLIV schools, we sent parents (via student backpack fliers) paper immunization consent forms and information about SLIV. E-mails were unavailable at these schools. Local health department nurses administered nasal or injectable influenza vaccine at dedicated SLIV clinics and billed insurers. We compared influenza vaccination rates at SLIV versus control schools using school directories to identify the student sample in each school. We used the state immunization registry to determine receipt of influenza vaccination. Results: The final sample comprised 17,650 students enrolled in the 20 schools. Adolescents at suburban SLIV schools had higher overall influenza vaccination rates than did adolescents at control schools (51{\%} vs. 46{\%}, p < .001; adjusted odds ratio = 1.27, 95{\%} confidence interval 1.18-1.38, controlling for vaccination during the prior two seasons). No effect of SLIV was noted among urbanschools on multivariate analysis. SLIV did not substitute for vaccinations in primary care or other settings; in suburban settings, SLIV was associated with increased vaccinations in primary care or other settings (adjusted odds ratio = 1.10, 95{\%} confidence interval 1.02-1.19). Conclusions: SLIV in this community increased influenza vaccination rates among adolescents attending suburban schools.",
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