School-based adolescent hepatitis B immunization programs in the United States: strategies and successes

To increase hepatitis B vaccination coverage of adolescents, a public/private partnership was organized in the greater Baton Rouge area of Louisiana in 1992 to fund and implement school-based vaccination programs.

Initial programs utilized schools with existing school-based clinics and administered 2 to 3 doses of hepatitis B vaccine to up to 76% of eligible students. During 1996 to 1997, expansion from 4 schools to 68 schools was facilitated by the use of temporary clinics set up in open school space. This multifaceted program administered 3 doses of hepatitis B vaccine to 3232 students (75%) and 2 doses to 171 students (4%). Administration of the 3-dose regimen of hepatitis B vaccine was aided by the use of a dosing schedule at 0, 2 and 4 months. This accelerated dosing has been shown to provide seroprotection for greater than 95% of healthy adolescents.

In the Baton Rouge area, the hepatitis B adolescent vaccination program has immunized approximately 5000 adolescents during a 5-year period with minimal use of financial and personnel resources.

The success and growth of this program demonstrate that school-based vaccination programs can be highly efficient and effective.