Implementing School-Associated Vaccination Events in Colorado Public Schools: A Statewide Survey of Nurses

Schools are important settings for delivering vaccines. It is unknown how facilitators of and barriers to implementing school-associated vaccination events (SAVEs) vary by school- and community-level characteristics.

We fielded a web-based survey of school nurses that worked in Colorado public schools in Fall 2024 to assess perceived implementation facilitators and barriers. We linked survey responses (n = 368) to publicly available data and conducted descriptive analyses.

Key facilitators identified by nurses that held SAVEs between 2018 and 2024 included parental awareness and trust, and external partnerships. Barriers identified by nurses who did not hold SAVEs included lack of guidance, staff time, and external partnerships. Across school characteristics, lack of guidance was ranked as one of the three most important barriers. Nurses in rural schools were more likely to rank vaccine politicization as a top barrier. Staff time was a top barrier for nurses in smaller schools, schools serving families with lower incomes, and high schools.

School nurses need guidance and external partnerships to successfully implement SAVEs.

Context-specific strategies to improve SAVE implementation will be critical to allow schools to contribute to keeping students, staff, and communities safe from vaccine-preventable diseases.