Current experience with school-located influenza vaccination programs in the United States: a review of the medical literature.

In the United States, all children 6 months through 18 years of age are recommended to be vaccinated against influenza annually. However, the existing pediatric immunization infrastructure does not have the capacity to vaccinate a high proportion of children each year. School-located influenza vaccination (SLIV) programs provide an opportunity to immunize large numbers of school-age children. We reviewed the medical literature in order to document the current U.S. experience to benefit future SLIV programs. Published reports or abstracts for 36 SLIV programs were identified, some of which spanned multiple years. The programs immunized between 70-128,228 students. While most programs vaccinated 40-50% of students, coverage ranged from 7-73%. Higher percentages of elementary students were vaccinated compared with middle and high school students. While many programs offered only intranasal vaccine, several programs have successfully used both the intranasal and injectable vaccines. Faculty and staff were immunized in some programs and uptake in this group varied considerably. Students were vaccinated quickly during school hours. Costs, where reported, ranged from approximately $20-$27 per dose delivered, including both vaccine and administration costs. The greatest need for future U.S. SLIV program implementation is the development of a financially sustainable model that can be replicated annually on a national scale.