Rapid, mass vaccination of the young presents a new logistical problem, one that many communities aren't yet able to solve.
"There are really two avenues to do this," says Dr. Peter Szilagyi, a pediatrician and expert in child immunizations at the University of Rochester Medical Center. "One is to grab every child when they are already there [at the doctor's office], use reminder mechanisms to bring people in and have special hours like weekends and evenings -- just make it very efficient. The other path is to think about using schools or other places for vaccination."
Some county health departments and school districts are doing just that.
"It's an appealing way to reach children," says Dr. Jeanne Santoli of the CDC. "But the primary business of schools is education. Schools don't want that to be compromised, and physicians don't want that to be compromised."
More than 30 of California's 58 counties will offer some form of school-based flu vaccine clinics this year, says John Talarico of the California Department of Health Services, up from 18 last year.
But a 2004 pilot study using schools to provide flu vaccination in San Bernardino County revealed the complexity of such an approach, says Dr. Gerald R. Greene, a pediatrician in Highland who helped coordinate the study.
The project required detailed planning, coordinated schedules and a multitude of volunteers, he says. Further, it was difficult to provide the immunization to students in the junior high and high schools because they change classrooms throughout the day and have busy schedules.
Even vaccinating elementary school children was a challenge, Greene says. Parental consent had to be obtained. And children under age 9 who were being vaccinated for the first time needed two doses of vaccine, which required a second trip to the school.
"Trying to bring vaccine to that many schools in a short amount of time requires effort and personnel that would go beyond those supplied by most school districts," Greene says.
Other health experts say families should turn to their regular doctor. "We think the best place for kids to get vaccinations is with the primary care provider," says Dr. Jonathan Fielding, director of L.A. County's Department of Public Health. "This should not require specialized care."
