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School-based health centers effective at increasing immunizations rates
Besides increasing vaccination rates, school-based immunization recall is cost-effective, according to study results published online.
Allison Kempe, MD, MPH, director of the Children’s Outcomes Research Program at the University of Colorado School of Medicine, and colleagues conducted a demonstration study of 265 girls who were due for one or more adolescent vaccinations and a randomized controlled study of 264 boys who were due for vaccines. Half of the populations received recall and half received standard care. The researchers assessed immunization rates 6 months after recall, and costs of the first doses were evaluated by direct observation and examining invoices.
Kempe and colleagues reported that recall was effective and economical: 77% of girls received one or more vaccines and 45% received all required vaccines, whereas 66% of boys received one or more vaccines and 59% received all vaccines. These results were significant compared with 45% and 36% in the control group. For girls, immunizations among those who needed each of the vaccines were 68% for tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, 57% for quadrivalent meningococcal conjugate (Menactra, Sanofi-Pasteur) vaccine, and 59% for the first dose of HPV vaccine. The researchers reported the range of cost to be $1.12 to $6.87 per recalled child who was immunized.
“The success of the intervention is particularly notable because it was conducted in a setting serving primarily low-income adolescents, a group that has, historically, been difficult to reach,” the researchers wrote. “Although [school-based health centers] are not very prevalent currently, their numbers may increase in the setting of recent health legislation establishing [school-based health centers] as sites for comprehensive primary care, which should enhance opportunities for billing and enhanced federal support.”
Disclosure: Dr. Kempe reports no relevant financial disclosures.