Challenged by Immunization Compliance? Five Steps for Nurses in Urban High Schools With Multilingual Students

Immunization compliance can require time and resources not readily available to school nurses in urban schools. Furthermore, immunizations can be perceived as lower priority at the high school level. But communicable disease outbreaks, such as the one experienced across the United States with measles, highlight the important role of school nurses in compliance activities. Using a five-step process, a school nurse was able to update one urban high school's database to more accurately reflect student measles vaccination compliance. An initial immunization database query indicated that 12% of approximately 2,000 enrolled students lacked even one measles-containing vaccine. A search through the state immunization registry and individual student educational folders revealed that 65% of these students actually had at least one measles vaccination. Remedies under consideration by the district in addressing this discrepancy are described. The remaining students (4% of total enrollment) required the additional steps of notification and intensive follow-up with students and their families. Within 2 months, fewer than 1% of students lacked a record of measles vaccination. The five steps presented can be adapted to achieve compliance with all required vaccines.