ASPPH logo


Member Research & Reports

Member Research & Reports

South Florida: Demonstrating an Immunization Compliance Strategy

Lack of immunization compliance is commonly due to lack of awareness, according to University of South Florida College of Public Health’s Dr. Jill Roberts, assistant professor in the Department of Environmental and Occupational Health.

Dr. Roberts’ new research, “An Evidence-Based Project Demonstrating Increased School Immunization Compliance Following a School Nurse-Initiated Vaccine Compliance Strategy” is published in The Journal of School Nursing.

She described a successful three-stage strategy to increase school immunization compliance at a Northern Indiana high school.

The doctor gave vaccination needle .

“The school is interesting is because the area is underserved,” Dr. Roberts said. “There is a high migrant population and high level of poverty, so some of the more advanced methods of reaching out to people to increase immunization rates aren’t going to work here.”

According to Dr. Roberts, relying on social media, email or text reminders—methods more currently used—will not work in a community that faces limited access to cell phones.

Using an evidence-based strategy, school nurse Ms. Wendy Swallow employed a three-step process to communicate with parents of teens who were not in compliance.

First letters from the school nurse were sent home with students indicating lack of compliance. The next stage involved a second letter with information from the Indiana State Department of Health, appointment information and a copy of the student’s immunization record.

“It’s one thing to say you need a chicken pox vaccine, but it’s another to say ‘Here’s where you can get it and here’s where you can get it for free,’ so including that information and putting all those factors together made compliance go way up,” Dr. Roberts said.

In the final stage, letters were sent home via email and phone calls were used for follow-up. In some cases, Roberts said, in person visits were made if no phone numbers or emails were listed.

Each letter sent home with students included an explanation of exclusion and a date the exclusion from school would apply, according to Dr. Roberts.

“Parents don’t know the immunizations are missing,” Dr. Roberts said. “But, a bigger thing is they don’t know the consequences of missing immunizations, so if the student is not immunized for a particular disease, they can’t come to school.”

Read more.