Using a school-based approach to deliver immunization—global update.

Vaccines, such as HPV vaccine, are increasingly administered to school-age children, and school-based immunization is an approach that can be used to reach these children. Limited information has thus far been published that provides an overview of the school-based approach worldwide. This article, based on self-reported data from countries, summarizes the extent to which a school-based immunization approach is used around the world, and what antigens are most frequently being administered. Of the 174 countries for which data on school-based immunization were available, ninety five countries reported using a school-based approach for immunization. Children in grades 1 and 6 (or at an age corresponding with these grades) are most often targeted, and tetanus and diphtheria toxoids are the most frequently administered antigens. The impact of the school-based approach may be reduced in areas with low school attendance, unless specific measures are taken to target out-of-school children. Methods to monitor coverage need to be standardized and data on coverage and on the reach of the approach need to be more systematically analyzed and reported.