Tips for Tdap triumph: implementing a statewide law in an urban school district

This article describes the implementation of a multi-grade immunization mandate and general strategies that can facilitate implementation. The experience is that of an urban school district in implementing California Assembly Bill 354 (AB 354), which mandated pertussis vaccination for adolescents in 7th through 12th grades by the first day of school in 2011. AB 354 provided hardly a year's notice in obligating health departments to increase access to vaccinations and the school districts in collecting proof of vaccination of students enrolled in six sequential grade levels. Key strategies in achieving compliance with adolescent vaccination mandates include the following: creating a task force that facilitates open and regular communication within the school district and with counterparts at the health department; having, in leadership positions, a high-level school administrator and a school nurse; ensuring that exclusions are effectively publicized and implemented; assuring that the database system allows school staff to generate real-time reports to monitor progress; providing all families with easy and low-cost access to immunizations while focusing on students who might be more vulnerable; and using traditional and electronic media to publicize the new requirement.