Coordination Costs for School-Located Influenza Vaccination Clinics,Maine,2009 H1N1 Pandemic

Abstract

School nurses played a key role in Maine’s school-located influenza vaccination (SLV) clinics during the 2009–2010 pandemic season. The objective of this study was to determine, from the school district perspective, the labor hours and costs associated with outside-clinic coordination activities (OCA). The authors defined OCA as labor hours spent by staff outside of clinic operations. The authors surveyed a convenience sample of 10 school nurses from nine school districts. Eight nurses responded to the survey, representing seven districts, 45 schools and 84 SLV clinics that provided a total of 22,596 vaccine doses (H1N1 and seasonal combined) to children and adolescents. The mean total OCA time per clinic was 69 hours: out of total hours, 22 (36%) were spent outside regular clinic operation time. The authors estimated the mean cost of OCA to be $15.36 per dose. Survey respondents reported that costs would be lower during non-pandemic seasons and as schools become more proficient at planning clinics.

Keywords

influenza vaccination pandemic H1N1 school nurse economic evaluation school-located vaccination clinics

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References

Bureau of Labor Statistics. (2009). Occupational employment statistics. Retrieved September 7, 2010, from Bureau of Labor Statistics website: http://www.bls.gov/oes/current/oessrcst.htm

Carpenter

(2007). Mass distribution of free, intranasally administered influenza vaccine in a public school system. Pediatrics, 120, e172.

Cawley

Hull

H. F.

Rousculp

M. D.

(2010). Strategies for implementing school-located influenza vaccination of children: A systematic literature review. Journal of School Health, 80, 167–175. doi:10.1111/j.1746-1561.2009.00482.x

Center for Disease Control and Prevention. (2009a). 2009 H1N1 influenza school-located vaccination (SLV): Information for planners. Retrieved April 28, 2011, from http://www.cdc.gov/h1n1flu/vaccination/slv/planners.htm#definition

Center for Disease Control and Prevention. (2009b). Use of influenza A (H1N1) 2009 monovalent vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. Morbidity and Mortality Weekly Report, 58, 1–8.

Center for Disease Control and Prevention. (2010a). Estimates of deaths associated with seasonal influenza—United States, 1976–2007. Morbidity and Mortality Weekly Report, 59, 1057–1062.

Center for Disease Control and Prevention. (2010b). Prevention and control of influenza with vaccines. Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. Morbidity and Mortality Weekly Report, 59, 1–62.

Center for Disease Control and Prevention. (2011). Local Health Department costs associated with response to a school-based pertussis outbreak—Omaha, Nebraska, September–November 2008. Morbidity and Mortality Weekly Report, 60, 5–9.

Cho

B.-H.

Asay

Lorick

Tipton

Dube

Messonnier

(2011). Estimated school influenza vaccination clinic cost—2009–2010 Influenza Season in the State of Maine. Retrieved from http://cdc.confex.com/cdc/nic2011/webprogram/Paper25309.html

10.

Effler

P. V.

Chu

Gaynor

Sakamoto

Nagao

Park

S. Y.

(2010). Statewide school-located influenza vaccination program for children 5–13 years of age, Hawaii, USA. Emerging Infectious Diseases, 16(2), 244–250.

11.

Hull

H. F.

(2010). A survey of physician-led influenza immunization programs in schools. Clinical Pediatrics, 49, 439–442.

12.

Hull

H. F.

(2011). Current experience with school-located influenza vaccination programs in the United States. Human vaccines, 7, 153.

13.

Hull

H. F.

Frauendienst

R. S.

Gundersen

M. L.

Monsen

S. M.

Fishbein

D. B.

(2008). School-based influenza immunization. Vaccine, 26, 4312–4313. doi:10.1016/j.vaccine.2008.06.015

14.

Humiston

Schaffer

Szilagyi

Long

Chappel

Szydlowski

Kolasa

(2011). A randomized control trial of elementary school-located influenza vaccination. Paper presented at the National Immunization Conference, Washington, DC. Retrieved from http://cdc.confex.com/cdc/nic2011/webprogram/Session11601.html

15.

King

J. C.

Jr Cummings

G. E.

Stoddard

Readmond

B. X.

Magder

L. S.

Stong

, … for the SchoolMist Study Group. (2005). A pilot study of the effectiveness of a school-based influenza vaccination program. Pediatrics, 116, e868–e873.

16.

King

J. C.

Jr Stoddard

J. J.

Gaglani

M. J.

Moore

K. A.

Magder

McClure

Neuzil

(2006). Effectiveness of school-based influenza vaccination. The New England Journal of Medicine, 355, 2523–2532.

17.

Lorick

S. A.

Goldberg

Birkhimer

Dube

Dutram

Hubley

Mills

(2011). Maine’s success story—H1N1 school influenza vaccination efforts, 2009-2010. Paper presented at the National Immunization Conference, Washington, DC.

18.

Ding

Euler

Furlow

Bryan

Bardenheier

Singleton

(2010). Interim results: State-specific Influenza A (H1N1) 2009 monovalent vaccination coverage—United States, October 2009–January 2010. Morbidity and Mortality Weekly Report,59(12), 363–368.

19.

Oostveen-Buterbaugh, C. J. (2009). Maine School Nurse Survey Results. Unpublished report. Main: Maine Centers for Disease Control and Prevention.

20.

Maine Department of Education. (2011). Free and reduced lunch statistics. Retrieved April 18, 2011, from https://portal.maine.gov/sfsr/sfsrdev.ed534.ed534_parameters

21.

Schmier

King

J. C.

Jr Nichol

Mahadevia

P. J.

(2008). Benefits and costs of immunizing children against influenza at school: An economic analysis based on a large-cluster controlled clinical trial. Health Affairs, 27, w96–w104. doi:10.1377/hlthaff.27.2.w96

22.

Shipman

S. A.

Lan

Chang

C.-h.

Goodman

D. C.

(2011). Geographic Maldistribution of Primary Care for Children. Pediatrics, 127, 19–27. doi:10.1542/peds.2010-0150

23.

Thomas

T. B.

Mills

D. A.

(2010). Maine CDC 2009 H1N1 influenza pandemic after action summary. Unpublished report. Retrieved from http://www.maine.gov/dhhs/boh/maineflu/h1n1-after-action-report-2010.pdf

24.

U.S. Department of Education. (2011). Local education agency (school district) universe survey data. Retrieved July 20, 2011, from http://nces.ed.gov/ccd/pubagency.asp.

25.

U.S. Department of Education. (2010). Institute of Education Sciences, National Center for Education Statistics, Common Core of Data. Retrieved on January 6, 2011 from http://nces.ed.gov/ccd/bat/.

26.

White

Lavoie

Nettleman

M. D.

(1999). Potential cost savings attributable to influenza vaccination of school-aged children. Pediatrics, 103, e73. doi:10.1542/peds.103.6.e73