6-12 Months Prior to School-Located Influenza Vaccination (SLIV) Clinic

• Determine which institution(s) will take primary responsibility to plan and implement the vaccination clinic (e.g., public health department [PHD], school system)
• Determine if the school superintendent is able to recommend the vaccination program to all schools in the district. If decisions to participate will be left up to individual principals at each school, ask the superintendent to schedule a meeting and/or webinar with principals to present the program. If unable to schedule a meeting, have the superintendent seek support by sending a letter of recommendation to each principal, and then determine who will be responsible for contacting each principal (e.g., county health department, community immunizer)
• Create a Steering Committee and Subcommittees, including an Immunization Committee and Public Relations (PR) Committee

Potential Steering Committee Membership:

1. State/county/local health department (required)
2. State/county/local school system (required)
3. Community pediatrician/family practitioner representatives
4. University divisions (e.g., school of nursing, school of public health, medical school, school of pharmacy)
5. University sororities/fraternities
6. Local hospitals
7. Local religious organizations
8. Medical Reserve Corps
9. Junior League
10. United Way
11. Chamber of Commerce

Potential Immunization Committee Membership:

1. Health department nursing supervisor
2. School system nursing supervisor
3. Clinical volunteers from universities/colleges
4. Medical Reserve Corps
5. Retired Nurses‘ Association
6. Community groups (to move students through clinics and to/from class)

Potential PR Committee Membership:

1. Health department public information officer
2. School system public information officer
3. Nurses‘ associations
4. Universities/colleges
5. United Way
6. Chamber of Commerce

Educate Relevant SLIV Clinic Stakeholders Regarding the Following Topics:

• In 1 year, the flu caused 38 million lost school days in the United States¹
• Children can be sick with the flu for a week or more²
• School-aged children can spread flu to other schoolchildren, family members, and the community^3,4
• Importance of offering a SLIV clinic:
  • Provide a convenient way for parents to have their eligible children vaccinated against the flu
  • Reach children who may otherwise miss a vaccination opportunity (many children do not visit their physician between August and April)
  • The Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics (AAP) have identified SLIV clinics as an important step in meeting the challenge of protecting more children against the flu^5,6

Set Program Structure and Goals:

• Assign role of local medical community communication liaison, typically a leading local pediatrician, pediatric infectious disease physician, or university-affiliated physician
• Determine what populations will be immunized (i.e., preschool, elementary, middle, and/or high school)
• Set a vaccination rate goal for the program to determine how many doses of vaccines are required
  • When factoring rates, consider vaccination rates, which vaccines are being offered, and available supply. For example: 30,000 total students K–12 with a vaccination rate goal of 35% yields the need for 10,500 doses initially, with supplemental vaccine doses for younger patients and vaccine-naïve children to receive second dose
  • Estimate amount of available vaccine doses through public sources by calculating Vaccine For Children (VFC)-eligible population. To do so, leverage state/county records, state vaccination registries, or number of children enrolled in free and reduced-cost lunch programs
• Develop funding plan as needed for vaccine purchase and program implementation
• Convene regular Steering Committee, Immunization Committee, and PR Committee meetings

• Confirm that the anticipated administrator of the SLIV clinic has established the capacity to bill insurance companies for utilization of products and services
  • Public health departments who have not previously billed payers may be able to seek guidance regarding how to establish billing capabilities by consulting with other health departments, local providers, or hospitals in the area who have experience billing vaccines and administration to payers
• Calculate the number of VFC-eligible and privately insured children in the school system as discussed in the public coalition SLIV clinic model component to determine appropriate amounts of vaccine to order
  • Example: 30,000 total students K–12 with a vaccination rate goal of 35% yields the need for 10,500 doses initially, with supplemental vaccine doses for younger patients and vaccine-naïve children to receive second dose. For initial dose, if the VFC population represents 60% of children and the privately insured population represents 40%, make plans to secure 6,300 VFC doses and 4,200 private doses through other channels, such as MMCAP*
• Information required:
  • Know which payers serve the local community; if unclear, call local providers and large employers, or consult payer websites
  • Confirm payer contracts are either in place or initiate contracting effort; alternatively, consider partnering with a local provider or a hospital that is contracted with private payers. In this instance, the health department would order VFC vaccines and the local provider or hospital would purchase and bill for private vaccines
  • Notify local payers and state about intention to run a SLIV clinic and note that they will be asked to reimburse for vaccines and administration
  • Determine payer general reimbursement rates for vaccines and administration to appropriately plan program finances
  • If health departments have previously billed payers for vaccines, consider researching past Explanations of Benefits (EOBs) to understand the basis for potential denials

*MMCAP=Minnesota Multistate Contracting Alliance for Pharmacy

• Select appropriate community immunizer partner:
  • Review service offerings
  • Evaluate prior seasonal flu SLIV clinic experience
  • Assess payer billing capacity and contracting status
  • Determine whether community immunizer is approved as a VFC provider or VFC contract service provider
  • Confirm that either the health department or community immunizer maintains inventory of selected vaccine formulations
• Assign roles and responsibilities to program stakeholders