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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Childhood Vaccination with MMR, Flu, and HPV.

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Strategy. School-Based Vaccination Programs

Approach. Implement school-based vaccination programs to increase vaccination rates among children.

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Overview. Implementing school-based vaccination programs involves establishing partnerships between public health departments, schools, and healthcare providers to deliver vaccines directly to students on school grounds.[1] This approach offers a convenient and efficient strategy to increase childhood vaccination rates by reaching a large captive audience within a familiar and trusted environment.[1] Key components include ensuring schools have the necessary infrastructure and qualified personnel to conduct vaccinations, developing clear communication materials to address parental concerns and obtain informed consent, and adhering to all relevant immunization guidelines set by health authorities.[1] Examples of successful public health programs utilizing school-based vaccination clinics include initiatives in Texas offering HPV vaccinations during school hours and programs in Vermont collaborating with schools to identify undervaccinated students and organize catch-up clinics specifically for them.[2, 3] Peer-reviewed research has shown that school-based vaccination programs are demonstrably effective in increasing childhood immunization rates.[2,3] Studies have found that these programs can significantly improve completion of recommended vaccinations, particularly for adolescents who may face challenges with transportation or parental involvement, and contribute to increased overall community immunity levels.[4]

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

This strategy is also supported as "Vaccination Programs: Schools and Organized Child Care Centers" in The Community Guide.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Staff/teacher polling on policy
  • School district information on policy
  • Utilization data

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Collaboration (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of schools that implement vaccination programs in partnership with the state health departments and providers. (Measures school vaccination program adoption and reach)
  • Number of students enrolled in school-based vaccination programs and eligible to receive immunizations. (Measures school vaccination program potential impact and scale)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of school vaccination clinics supported by Title V that are held at convenient times for students and families, such as during school registration or orientation. (Measures school vaccination program usability and fit with preexisting school routines)
  • Percent of school vaccination programs supported by Title V that have a clear and efficient process for obtaining and documenting parental consent. (Measures school vaccination program communication and engagement with families)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of school districts partnered with Title V that adopt policies and procedures to institutionalize vaccination programs and ensure consistency across schools. (Measures systemization and sustainability of school-based vaccination programming)
  • Number of schools partnered with Title V that implement multi-component strategies to promote vaccination, including education, rewards, and peer support programs. (Measures breadth of comprehensive approaches to school-based vaccination programming)
  • Number of schools partnered with Title V that consistently achieve and maintain student vaccination rates above state and national benchmarks. (Measures sustained impact and performance of school vaccination program)
  • Number of school days saved and academic outcomes improved as a result of reduced student illness and absenteeism due to increased vaccination. (Measures educational and societal impact of school vaccination program)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of school districts partnered with Title V that adopt policies and procedures to institutionalize vaccination programs and ensure consistency across schools. (Measures systemization and sustainability of school-based vaccination programming)
  • Percent of schools partnered with Title V that implement multi-component strategies to promote vaccination, including education, rewards, and peer support programs. (Measures breadth of comprehensive approaches to school-based vaccination programming)
  • Percent of schools partnered with Title V that consistently achieve and maintain student vaccination rates above state and national benchmarks. (Measures sustained impact and performance of school vaccination program)
  • Percent of school days saved and academic outcomes improved as a result of reduced student illness and absenteeism due to increased vaccination. (Measures educational and societal impact of school vaccination program)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] “You Call the Shots: Vaccines Web-Based Training Course.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 25 Mar. 2024, www.cdc.gov/vaccines/ed/youcalltheshots.html.

[2] “Immunizations.” Immunizations | Texas DSHS, www.dshs.texas.gov/immunizations.

[3] “Immunization Information for Child Care and School Providers.” Vermont Department of Health, www.healthvermont.gov/disease-control/immunizations.

[4] Borràs, E., Domínguez, A., & Salleras, L. (2011). Assessing the effectiveness of vaccination programs. Gaceta Sanitaria, 25, 49-55.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.