Background: Despite efforts to enhance influenza vaccination among persons at highest risk of complications, influenza remains a health burden in the United States. Evidence indicates that vaccination of elementary school children protects them from influenza, and reduces transmission. However, there are no published intervention trials demonstrating the impact of strategies designed to enhance influenza vaccination rates specifically among adolescents. Objective: Assessing the efficacy of two multi-component interventions designed to enhance influenza vaccination rates among adolescents attending middle- and high-schools in three rural counties in Georgia, U.S.A. Methods: This study employs a non-randomized, threearmed controlled design across 2 years. The three arms consist of: 1) a multi-component school-based influenza vaccination intervention condition (County 1), 2) a multicomponent provider-based influenza vaccination condition (County 2), and 3) a standard of care condition (County 3). The multi-component interventions each consisted of a structural component (school-based or provider-based provision of influenza vaccination) and an educational component (a brochure and a school skit), designed to enhance vaccine education among adolescents and their parents. Results: During the 2008 to 2009 influenza season in County 1, there were 70 students vaccinated out of 370 students (18.9%). During the same year in County 2, there were 110 out of 736 students vaccinated (14.9%). In the first year, students in County 1 were 25% more likely to be vaccinated than students in County 2 (RR = 1.26, 95% CI: 0.96-1.66). During the current 2009-2010 influenza season, in County 1 we have vaccinated 114 out of 375 students (30.4%), a 62.2% increase from the previous influenza vaccination season. Currently, in County 2 we have vaccinated 10.5% of students (70 out of 663). For the current influenza season, students in County 1 are almost 200% more likely to get vaccinated than students in County 2 (RR = 2.88, 95% CI: 2.20-3.77). Conclusion: We have observed a greater percentage of students vaccinated in the school-based intervention than in the provider-based intervention during the previous and current influenza seasons (p = 0.0912 and p < 0.0001, respectively). This study has implications for best practices for mass campaigns during an influenza pandemic, such as the current H1N1 influenza pandemic. This study is funded by CDC 5 R18 IP000166.
Gargano, L. M., Pazol, K., Painter, J. E., Sales, J. M., Murray, D., Morfaw, C., … Hughes, J. M. (2010). Influenza vaccine delivery to adolescents: Assessment of two multicomponent interventions. International Journal of Infectious Diseases, 14, e319–e320. https://doi.org/10.1016/j.ijid.2010.02.2200