Multicomponent interventions to enhance influenza vaccine delivery to adolescents

Lisa M. Gargano, Karen Pazol, Jessica M. Sales, Julia E. Painter, Christopher Morfaw, La Dawna M. Jones, Paul Weiss, James W. Buehler, Dennis L. Murray, Gina M. Wingood, Walter A. Orenstein, Ralph J. DiClemente, James M. Hughes

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: To compare school- versus provider-based approaches to improving influenza vaccination coverage among adolescents in rural Georgia. METHODS: We used a nonrandomized, 3-armed design: (1) a middle-and high school-based influenza vaccination intervention in 1 county; (2) a provider-based influenza vaccination intervention in a second county; and (3) a standard-of-care condition in a third county. Interventions also included distribution of an educational brochure, school presentations, and community-based outreach to enhance vaccine knowledge and awareness among adolescents and their parents. RESULTS: During the 2008-2009 influenza season, 70 (19%) of 370 students were vaccinated in the school-based county and 110 (15%) of 736 students were vaccinated in the provider-based county, compared with 71 (8%) of 889 students in the standard-of-care county (risk ratio [RR] school: 2.4 [95% confidence interval (CI): 1.7-3.2]; RR provider: 1.9 [95% CI: 1.4 -2.5]). During 2009 -2010, seasonal influenza vaccination coverage was 114 (30.4%) of 375 of students in the school-based county, 122 (16.9%) of 663 of students in the provider-based county, and 131 (15.2%) of 861 students in the standard-of-care county (RR school: 2.3 [95% CI: 1.9 -2.9]; RR provider: 1.2 [95% CI: 0.97-1.5]). CONCLUSIONS: Special efforts to promote influenza vaccination among rural, predominantly black students were associated with increased vaccination coverage. The school-based influenza vaccination intervention was associated with the highest levels of vaccination coverage. This study revealed the efficacy of school-based influenza education to improve vaccination rates among adolescents.

Original languageEnglish (US)
Pages (from-to)e1092-e1099
Issue number5
StatePublished - Nov 2011


  • Adolescents
  • Influenza vaccine
  • Pandemic preparedness
  • School-based clinics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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