Beat The Flu In Your School

1
Beat The Flu In Your School

• CT-AAP CT DPH Teleconference
• March 19, 2009
• Joan Cagginello, RN, MS
• Milford Health Department

2
School Influenza Clinics

• November 2008
• 3 School Clinics
• 1st Venture
• Collaborative Effort
• Positive Outcomes/Challenges Faced

3
Milford Health Department

• Local Health Department
• Serve City of Milford-approx 55,000 residents
• Located midway between Bridgeport New Haven on
  the I-95 corridor
• Public Services include School Nursing/Public
  Health Nursing, Sanitarians, Health Education,
  Epidemiology, Housing Inspectors, Emergency
  Preparedness

4
Milford Health DepartmentImmunization Program
Monthly Immunization Clinic For Adults Children
Annual Influenza Campaign
On-call Immunizations for School Children
VNA Well Child Clinic
5
Milford Schools

• 15 Public Schools with approx 7,500 students
• 9 Elementary
• 3 Middle Schools
• 2 High Schools
• 1 Alternative HS
• 4 Parochial Schools with approx 1,000 students
• 3 Elementary
• 1 High School

6
Why A School Influenza Prevention Program?

• CDC AAP recommendations to vaccinate 6mos-18
  yrs.
• Required expanding our influenza vaccination
  program for children

7
School Influenza Prevention Program Collaboration

• Collaboration is KEY
• Milford Health Department
• Milford Public Schools
• CT Department of Public Health-Immunization
  Program

8
Collaboration

• Milford Health Department
• Permission
• Logistics
• Planning
• Milford Public Schools
• Permission
• Advertising/Publicity
• Support
• CT Department of Public Health
• Influenza Vaccine VFC Influenza Vaccine
• Planning Guidance

9
Once you have the Go Ahead

• Select schools to hold clinics
• Determine if during school hours or after school
• Scheduling Logistics
• Speak with the Principal of the building
• Engage your school nurses
• Begin publicity campaign
• Determine LAIV or TIV (or both) Acquire vaccine
• Determine staffing needs
• Contact PCPs in area to inform
• Determine documentation method and notices for
  recall (those needing booster dose)

10
Selection of School(s)

• We selected our 3 middle schools
• We considered
• Geographical Location in the City
• Access outside/inside building
• Willingness of the building Administrator
• Availability of an appropriate size room during
  clinic hours
• (1 School Clinic held on Election Day as a
• Vote Vax Clinic in the Mobile Field
  Hospital)

11
During School Hours vs. After School Hours

• During School Hours
• Pros
• captive audience
• Greater potential for immunizing high percentage
  of students.
• Parents wont miss work.
• Not overtime for school nurses.
• Cons
• Students afraid to get a shot
• at school.
• Many logistics before clinic day.
• Time away from learning in class.

• After School Hours
• Pros
• Parent present to provide reassurance to child.
• Permission slips completed at time of clinic.
• Room availability is greater.
• Parents can bring all children to one location
  for immunization.
• Cons
• Parents need to return to school/possibly miss
  work.
• Staffing is an overtime issue.

12
Scheduling Logistics

• Clinics held from 3 pm-530 pm
• WSMS clinic held in Art Room
• ESMS clinic held in cafeteria
• Registration Table MHD Secretary
• 4 Work Stations to allow for privacy as needed
• Tables, chairs, wastebaskets, pens, forms
• School Health Office refrigerator as needed
• Lead Nurse Nurse Administrator available for
  questions

13
Coordinate with Principal

• Regardless of having Superintendent permission
  you must speak with Principal
• He/she will designate room assist with
  logistics publicity
• He/she will support your program to school staff
  and families

14
Engage your School Nurses

• They are integral to the success of your school
  clinics
• They are aware of children with special health
  concerns
• The school children staff know her and trust her

15
Publicity Campaign

• MHD Website
• MPS Website
• School Websites
• Flyer (elementary schools)
• School newsletter articles
• Family Resource Center newsletter

• Press releases
• Government Channel Stream/Scroll
• Connect Ed message from the Superintendent
• School Nurses informing their students families

16
Acquire VaccineTIV, LAIV or Both?

• LAIV FluMist administered via nasal spray
• TIV Flu Shot administered by IM injection

17
Acquire VaccineLAIV, TIV or both

• The MHD program used TIV only
• We purchase TIV from the State contract
• We acquired additional VFC doses for the school
  program from the Immunization Program

18
Registration Cost

• VFC eligible No Charge
• 20 for those ineligible for VFC
• Cash/Check receipt provided
• Registration and fee collection by MHD Secretary

19
Determine Staffing Needs

• Clinics staffed by our school nurses
• We scheduled 4 school nurses and a lead nurse for
  each 2.5 hour clinic
• They required minimal training as they have
  worked at monthly Immunization Clinic

20
Staffing School Clinic/Vote Vax

• Clinic open from 630 am-8 pm
• School Nurses and Volunteer Medical Reserve Corp
  Nurses (MRC) staffed Clinic
• Pre-training session held for MRC nurses
• Just In Time Training provided on the day of
  the clinic for all nurses
• Many had not administered to children

21
Contact Primary Care Providers

• Personally called each Pediatric Practice to
  inform them of the school program
• Delayed school program until November gave PCP
  opportunity to immunize their patients

22
Documentation

• Permission Slip and Vaccine Information Sheet
  (VIS)
• Provided a recall reminder sheet for those
  requiring a booster
• Entered information into MHD database for 2008-09
  flu season

23
Lessons Learned

• Collaboration is essential
• Planning should begin in August
• Need to plan for staffing allow for recruitment
  training of volunteers
• Determine your funding sources early
• Remember to be flexible!

24
Challenges

• Funding a program for all school children
• Designing a program that is sustainable
• Educating parents about the importance of annual
  influenza vaccination for their children

25
Challenges

• The ultimate challenge for us in public health
  and school health, is to find the most effective
  and efficient model to deliver flu vaccine.
• Our schools provide that model for delivery to
  school age children