Statewide school-located influenza vaccination program for children 5–13 years of age, Hawaii, USA

DOI: 10.3201/eid1602.091375
Suggested citation for this article: Effler PV, Chu C, He H, Gaynor K, Sakamoto S, Nagao M, et al. Statewide school-located influenza vaccination program for children 5–13 years of age, Hawaii, USA. Emerg Infect Dis. 2010 Feb; [Epub ahead of print]
Statewide School-located Influenza Vaccination Program for Children 5–13 Years of Age, Hawaii, USA
Paul V. Effler,1 Carl Chu, Howard He, Kate Gaynor, Steve Sakamoto, Marcia Nagao, Lisa Mendez, and Sarah Y. Park

Author affiliations: State of Hawaii Department of Health, Honolulu, Hawaii, USA

1Current affiliation: Department of Health, Perth, Western Australia, Australia.
New guidance recommends annual influenza vaccination for all children 5–18 years of age in the United States. During 2007–2008, Hawaii offered inactivated and live attenuated influenza vaccine at school-located clinics for grades kindergarten through eight. Most (90%) public and private schools participated, and 622 clinics were conducted at 340 schools. Of 132,775 children 5–13 years of age, 60,760 (46%) were vaccinated. The proportion vaccinated peaked at 54% for those 6 years of age and declined for older cohorts. More than 90% of schoolchildren transited the clinic in <10 minutes. A total of 15,835 staff-hours were expended; estimated cost per dose administered was $27 and included vaccine purchase and administration, health staffing resources, printing costs, data management, and promotion. This program demonstrates the feasibility of conducting mass school-located influenza vaccination programs in public and private schools statewide, as might be indicated to respond to pandemic influenza.

Seasonal influenza reportedly results in 200,000 hospitalizations and 36,000 deaths annually in the United States (1). In addition, ≈31 million outpatient visits are attributable to influenza during seasonal epidemics; annual projected direct medical costs are $10.4 billion and lost earnings are $16.3 billion (2). Although schoolchildren are not considered at high risk of dying from influenza, annual illness attack rates in schoolchildren were >40% in some years (3,4). In addition, children 5–18 years of age may be the primary source of communitywide...

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