Universally Recommended Vaccinations: Vaccination Programs in Schools & Organized Child Care Centers

Vaccination programs in schools or organized child care centers are multicomponent interventions delivered on-site to improve immunization rates in children and adolescents.  These programs include two or more of the following components:

1. Immunization education and promotion
2. Assessment and tracking of vaccination status
3. Referral of under-immunized school or child care center attendees to vaccination providers
4. Provision of vaccinations 

Additional components such as reduced client out-of-pocket costs, client incentives, and enhanced access to vaccination services may be provided. 

Organized child care centers include non-home day care, nursery or pre-school, and federal Head Start settings for children aged 5 years and younger. In most states, laws establishing vaccination requirements for school and child care center attendance require assessment, documentation, and tracking specific to each vaccine. Vaccination programs considered in this review either expanded the assessment and tracking process to other immunizations or conducted additional interventions. Vaccination programs are often collaborations between the school or child care center and local health departments, private healthcare providers, or community healthcare services. 

Summary of Task Force Recommendations & Findings

The Community Preventive Services Task Force recommends school and organized child care center-located vaccination programs based on strong evidence of effectiveness in increasing vaccination rates, and in decreasing rates of vaccine-preventable disease and associated morbidity and mortality.

The updated Task Force recommendation is based on findings from 27 studies in which vaccination programs in schools or child care centers:

1. Provided vaccinations on site
2. Were administered by a range of providers including school health personnel, health department staff, and other vaccination providers
3. Were delivered in a variety of different school and organized child care settings
4. Delivered one or more of a range of vaccines recommended for children and adolescents
5. Included additional components such as education, reduced client out-of-pocket costs, and enhanced access to vaccination services

School- and organized child care center-located vaccination programs may be most useful in improving immunization rates among children and adolescents for new vaccines, and vaccines with new, expanded recommendations (such as the annual immunization for seasonal influenza) where background rates are likely to be very low and improvements in coverage are needed.

Task Force Finding & Rationale Statement

Publications

The findings and results of this systematic review have not been published. Read other Community Guide publications about Vaccinations to Prevent Diseases in our library, including articles about the previous review. You may also subscribe to be notified as new materials on this topic become available.

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Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Universally recommended vaccinations: vaccination programs in schools & organized child care centers (abbreviated). www.thecommunityguide.org/vaccines/universally/schools_childcare.html. Last updated: MM/DD/YYYY.

Review completed: June 2009