School-located vaccination (SLV) has a long history in the United States and successfully contributed to lower morbidity and mortality due to vaccine-preventable diseases.
The school is an ideal place to reach families from all cultures, socioeconomic groups, abilities, languages, and age groups. It is conveniently located in a familiar and trusted community environment. The National Association of School Nurses has a position statement for using school-located vaccination events.
Colorado School Entry Immunization Law (25-4-901 et seq, C.R.S) and Colorado Board of Health rule (6 CCR 1009-2) require students who attend school to be vaccinated against certain diseases unless an exemption is filed, protecting students and communities from vaccine-preventable diseases.
Per Centers for Disease Control and Prevention, physicians and other pediatric vaccine providers should participate in events that eliminate barriers to vaccination, including:
- Unnecessary pre-requisites for receiving vaccines, and
- Missed opportunities to vaccinate.
Simultaneously, CDC encourages administering as many vaccine doses as possible as indicated on the recommended immunization schedules for persons aged 0 through 18 years.
Some students will need additional doses of school-required or routinely recommended vaccines to catch them up according to their age.
If applicable, Colorado law requires the parent/guardian to submit a signed written plan for obtaining the remaining school-required vaccines, following the ACIP schedule for minimum intervals and ages.
The role of the vaccine provider is to write the plan and provide follow-up instructions and referrals for continued immunization services.
Using reminder/recall strategies, ensure children are catching up or staying on track for school-required and recommended vaccines.
Consider providing this sample parent communication to parents/guardians before they leave the SLV event.
To support a successful event:
- Review CDC’s mass vaccination clinic planning activities.
- Follow the requirements within the CDC’s storage and handling toolkit.
- If you are a VFC provider, know the program’s requirements for vaccine transfers and off-site clinics.
- A collaborative approach is essential. Review CDPHE’s “I am a school” webpage for additional information.
- Work closely with the school and assign clear roles and responsibilities.
- Review the steps for planning and implementing a SLV event.
- Outline the scope of your SLV event with your school partner.
- Understand the needs of the population who will be vaccinated and balance those with your capacity as a provider.
- Outline the scope of your SLV event with your school partner.
- If possible, work together to pre-register students, including gathering consent forms. Collectively promote the event.
- Work together to address common challenges.
Use best practices for immunization record documentation.
The following links include resources and training for immunization and exemption documentation and running various reports in the Colorado Immunization Information System.
For assistance with CIIS, email cdphe_ciis_schools@state.co.us.
Colorado Immunization Information System (CIIS)
- About the Colorado Immunization Information System (CIIS)
- CIIS general job aids
- Exemptions
- Exemptions webpage, including the Online Immunization Education Module (does not require the signature of an immunizing provider)
- How to enter a Certificate of Medical Exemption
- How to enter a Certificate of Nonmedical Exemption
- CDPHE staff automatically enter nonmedical exemptions submitted via the Online Immunization Education Module into CIIS within two to three business days.
- Per SB 20-163, there is no requirement for providers to sign a Certificate of Nonmedical Exemption, but they are required to submit immunization, medical, and nonmedical exemption data to CIIS.
- Per Colorado Revised Statutes 25-4-2403(2.5) and 25-4-2403, immunizing providers are required to submit immunization, medical exemption, and nonmedical exemption data into the Colorado Immunization Information System.
- Parents/guardians, emancipated students, or students 18 years or older have the option of obtaining a nonmedical exemption without a provider's signature by completing the Online Immunization Education Module.
- Reviewing Certificates of Nonmedical Exemption for school and child care staff.
Resources
Vaccination clinic toolkits and resources
- Association for Immunization Managers: School-located vaccination clinic toolkit
- Minnesota Department of Health: Recommendations for welcoming and inclusive vaccine sites
- CDC vaccination schedule (birth to 18 years old)
- Immunize.org
Checklists:
- Checklist of best practices for vaccination clinics
- Association for Immunization Managers: School nurse vaccine clinic checklist
- Satellite, temporary, and off-site vaccination clinic supply checklist
Resources for families:
- Interactive FAQ about vaccinations from the American Academy of Pediatrics
- American Academy of Pediatrics website with videos on how vaccines work, myths about vaccines, etc.
- Vaccine hesitancy toolkit
- Vaccine Education Center at the Children’s Hospital of Philadelphia
- Children's Hospital of Philadelphia vaccine mobile app (for iPhone or Android). Information includes:
- Vaccines and the diseases they prevent
- Vaccine safety topics, including autism, thimerosal, and too many vaccines
CDPHE’s Immunization Branch is here to help. Contact our staff with questions.