Brick by Brick: Vaccine Clinics in Schools

School-hosted clinics improved access to the COVID-19 vaccine, but vaccine hesitancy may have prevented families in disadvantaged neighborhoods from getting vaccinated.

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COVID-19 vaccines were rolled out at “warp speed” in early 2021. By October 2021, all children over five years old were eligible for their first doses. Boosters were available to everyone by May 2022. Still, some parents did not make appointments for their families. Others did, but did not show up.

Los Angeles families in economically disadvantaged neighborhoods often lack the time, resources, and motivation to make and attend vaccine appointments at pediatricians’ offices. To help these families get vaccinated, 1,050 schools within 67 school districts opened vaccine clinics.

The county developed and used their Healthy Places Index to distribute vaccine resources to schools. Each zip code in the county received a health score based on COVID-19 vaccine uptake, infection rates, and other social factors. Schools in zip codes with the lowest scores were of highest priority (HPI+) and were given first access to vaccines and staff. The other schools were considered low-priority (Non-HPI+).

Schools recruited families through flyers based on templates from the Department of Public Health. These were posted online and distributed at school dismissal.

Cassandra Fink Biederman and colleagues evaluated the school clinic program’s impact on vaccine uptake. As shown in the figure above, the median number of vaccinations per school was highest in low-priority schools (shown in the dashed line). These schools held fewer clinic days than high-priority schools (shown in the blue and yellow bars), as they were given fewer resources. Still, many delivered more doses than high-priority schools (shown in the solid line). The researchers suggest that vaccine hesitancy may have prevented families in disadvantaged areas from getting vaccinated.

While school-hosted clinics improved vaccine access, schools’ recruitment efforts did not effectively promote vaccine confidence. The authors recommend that, during future vaccine rollouts, schools should partner with local health centers and trusted community members to motivate hesitant families. Schools may also issue vaccine mandates with minimal exemptions to improve uptake in schoolchildren.

Databyte via Cassandra Fink Biederman, Matthew A. Pham, Lily Jimoh, et al. School-Located Vaccine Clinics: An Effective Strategy for Expanding Access to COVID-19 Vaccines in Los Angeles CountyPublic Health Reports, 2023.