Original articleSchool-Located Vaccination of Adolescents With Insurance Billing: Cost, Reimbursement, and Vaccination Outcomes
Section snippets
Study setting
This study was conducted during the 2010–2011 school year in the Denver Public Schools, an urban public school district with approximately 74,000 students in kindergarten through high school. The human subjects review boards at the University of Colorado and the school district approved the study; informed consent for study participation was not required.
Study schools
Sixteen Denver public schools were eligible to participate, representing all noncharter sixth- to eighth-grade schools and a random sample of
School characteristics
The characteristics of intervention and control schools are listed in Table 1. The seven intervention schools had a median school enrolment of n = 289 sixth- to eighth-grade students (range, 111–951); the seven control schools had a median enrolment of n = 350 sixth- to eighth-grade students (range, 156–977).
Vaccination program characteristics
During the 2010–2011 school year, the total student body in intervention schools was 3,144; because influenza vaccine was offered, all students were assumed to need at least one vaccine.
Discussion
In a school-located adolescent vaccination program designed to bill for vaccination services provided, we found that privately insured, publicly insured, and uninsured students participated, the program was able to bill for vaccination, and the program increased the likelihood that students received Tdap, MCV4, and HPV vaccines. Overall, 41% of total program costs were reimbursed, with 78% of vaccine purchase costs and 14% of vaccine administration costs recouped through billing. Several
Acknowledgments
This investigation was supported by Cooperative Agreement #U01-1P00016-01 from the Centers for Disease Control and Prevention. The findings and conclusions are solely the responsibility of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. This investigation would not have been possible without the strong support of Denver Public Schools personnel, including Donna Shocks, M.S.N., C.N.S., R.N., manager of Nursing and Student
References (40)
- et al.
Parental views of school-located delivery of adolescent vaccines
J Adolesc Health
(2012) - et al.
School-located influenza immunization programs: Factors important to parents and students
Vaccine
(2012) - et al.
Voluntary school-based human papillomavirus vaccination: An efficient and acceptable model for achieving high vaccine coverage in adolescents
J Adolesc Health
(2010) Prevention and control of meningococcal disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR Recomm Rep
(2005)Preventing tetanus, diphtheria, and pertussis among adolescents: Use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR Recomm Rep
(2006)Quadrivalent human papillomavirus vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR Recomm Rep
(2007)Prevention and control of influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR Recomm Rep
(2010)Recommended immunization schedules for persons aged 0–18 years – United States
Morb Mortal Wkly Rep
(2011)- et al.
Additional health care visits needed among adolescents for human papillomavirus vaccine delivery within medical homes: A national study
Pediatrics
(2007) - et al.
Adolescent immunizations: Missed opportunities for prevention
Pediatrics
(2008)
Underinsurance among children in the United States
N Engl J Med
The role of schools in strengthening delivery of new adolescent vaccinations
Pediatrics
Delivering adolescent vaccinations in the medical home: A new era?
Pediatrics
Vaccines for Children program, United States
Pediatrics
Gaps in vaccine financing for underinsured children in the United States
JAMA
Design and analysis of group-randomized trials: A review of recent methodological developments
Am J Public Health
Design and analysis of group-randomized trials: A review of recent practices
Am J Public Health
Family Educational Rights and Privacy Act (FERPA)
HIPAA-FERPA revisited
J Sch Nurs
General recommendations on immunization—recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR Recomm Rep
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Conflicts of Interest: The authors have no conflicts of interest relevant to this article to disclose.
Financial Disclosure: Dr. Daley has received an honorarium from McGraw-Hill publishers for writing a book chapter on immunization.