Hertfordshire Community Trust (HCT) deliver the school-aged immunisation programme across Hertfordshire, Norfolk, Suffolk, Cambridge and Peterborough and is known as the Community and School Aged Immunisation Service (CSAIS).
Delivering over ½ million vaccines a year during our school-aged programme alone, the teams are knowledgeable about how to run effective sessions and the particularities of each school.
The principles are:
- Preparation – starts weeks before a session in a school.
- Well-trained staff members who are assessed as competent to deliver the programme, confident in the programme they are delivering and have access to clinical support.
- Documentation – patient group directions, standard operating procedures and risk assessments completed, accessible and signed as appropriate.
- Consent – requested from parents/carers in advance, on the day if required.
- Administration – strong administration support prior to and on the day of the session aids smooth running.
- Vaccine storage – strict adherence to cold chain policy. Investment in good quality vaccine porters supports the teams to comply. Clear pathways should be in place in the event of excursions. Use of data loggers both in the transportation and storage of vaccine.
- Regular feedback sessions to reflect on issues and make improvements.
‘… it is also important to have clinic sessions arranged for evenings and weekends. This is to support young people who were not happy to be vaccinated at school or who have missed the school vaccination session due to absence.’
In addition to the school session, it is also important to have clinic sessions arranged for evenings and weekends. This is to support young people who were not happy to be vaccinated at school or who have missed the school vaccination session due to absence. These clinics should be direct booking or walk ins, depending on your knowledge of the local area; often a mixture of the two approaches is appropriate. The clinics are arranged at local community centres and places of worship, which generally sit at the heart of communities and encourage support from community and faith leaders. Accurate data helps us to pinpoint areas of low vaccine uptake and we organise our clinics within these areas. HCT also offers home visits, where appropriate, and we even team up with our Special Care Dental service to vaccinate young people under sedation, who would not tolerate vaccination in usual circumstances.
We suggest a mixed-model, flexible approach for the successful vaccination of school-aged young people.
‘We suggest a mixed-model, flexible approach for the successful vaccination of school-aged young people.’
Table 1. Preparing for, delivering and following up a school-based immunisation session
| In advance | Know your schools – know what works best for the demographic in the school, e-consent or paper consents? Understand the format of the school day. |
| Build and maintain relationships – having a dedicated contact within the immunisation team (both an administrative and clinical perspective). The school helps to maximise consents received in advance and the smooth running of the session on the day. | |
| Offer to speak at assemblies and be present at parents' evenings to discuss concerns with students and parents/carers. | |
| Run reports of missing vaccines outside of the programme being delivered – for instance MMR. Obtain consent for these vaccines. | |
| Work with the school to chase missing consents/non-consents. | |
| Contact parents/carers by telephone for verbal consent to vaccination, if written consent is not received. | |
| On the day | Start early – collect vaccines and set up before the start of the school day. The morning is the most productive time and you do not want to waste a second. |
| Set up a water station. | |
| Consider Wi-Fi – is ‘guest Wi-Fi’ going to support all the programmes you need to run? | |
Allocate a lead nurse who completes a session risk assessment. Some considerations include:
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| Set up a private quiet area and crash mat for nervous and faint young people or those that wish to speak in private. | |
| Ensure all young people in the year group are bought to the session, irrespective of whether a consent has been received. Parental verbal consent can be obtained on the day (calling the parent/carer from the young person's phone can prove to be productive), or the young person can be assessed for Gillick competence and self-consent obtained. | |
| Lead nurse to ensure smooth flow of young people – not too many that the young people are waiting unreasonable amounts of time and not too few that the nurses have no one to vaccinate. | |
| As vaccines are administered, they are recorded on the e-consent portal which then uploads the information to clinical system as well as sending an email confirmation to parents/carers. Any young person vaccinated whose consent is not on the e consent portal will receive the patient information leaflet and the vaccine will be recorded directly on to the clinical system at the point of administration. | |
| Vaccine porter temperatures are recorded hourly, and vaccines are removed only as required. | |
| After the session | The GP is automatically advised via our systems of the vaccine given. |
| Where an e-consent has been completed but no vaccine was recorded on the day, a link is sent out the parent/carer to directly book into an evening or weekend clinic. | |
| Vaccines given data is fed into an internal uptake monitoring system. | |
| An email is sent to the school thanking them for their support, asking for feedback and raising any issues to ensure the smooth running of sessions in the future. | |
| Second visits planned, if required, to drive up uptake. |