Reaching More Children With the COVID Vaccine

The approval of COVID-19 vaccines for children was an important milestone in the battle against the pandemic, but it raised a question for Nationwide Children’s Hospital and many others who care for children:

How do we get as many young people vaccinated as efficiently as possible?

Through a combination of efforts and strategies, the hospital has been able to vaccinate 11,000 children with school-based services in central Ohio who might not have had access to the vaccine otherwise.

Nationwide Children’s experts join medical groups around the world in saying that vaccines, along with other measures such as masking and physical distancing, are critical in stopping the spread of COVID-19. The hospital saw that many families were immediately seeking out a vaccine as soon as it was approved for young people, said Tifini Ray, MPH, project manager for Care Connection at Nationwide Children’s.

They would schedule an appointment online and travel to a centralized clinic, like those run by Nationwide Children’s, other health care organizations and public health agencies.

There were almost certainly other families, however, who wanted the vaccine for their children but didn’t have easy access to one; parents couldn’t get time off from work, or didn’t have reliable transportation, or faced other barriers.

Nationwide Children’s has seen this problem before, regardless of the pandemic – overcoming obstacles to deliver care to a child. And one of the hospital’s most successful strategies has been the school-based health program called Care Connection. There are now Nationwide Children’s primary care inside 14 local schools, along with two mobile health clinics, a school-based wheelchair clinic and a diabetes clinic. Asthma therapy is in 254 schools.

“The whole idea of school-based care is going where the children are,” said Mary Kay Irwin, EdD, senior director of School Health Services at Nationwide Children’s. “Our ultimate goal is to connect children and families to a medical home. School based care is a way to link them to physical and behavioral health care they need. Vaccines, and in this case COVID-19 vaccines, are crucial preventive care.”

Through Care Connection, Nationwide Children’s began working with more than a dozen school districts in central Ohio to vaccinate young people for COVID in the schools themselves. The first clinics were held in high schools in April 2021, when only those 16 and older were eligible. As approvals for younger children happened, the clinics expanded.

The most recent push has been for children 5-11 years old, in November and December. The strategies for reaching the most children possible change from district to district, as the demographics of the students change, Ray said.

“In many of the suburban school districts, we were able to set up a clinic at one location, and the parents would sign up online, and we had a lot of success,” she said. “That was not going to work in Columbus City Schools, which has such a diverse mix of students and families. So we ended up going to every elementary and middle school. We tried different communication channels. Online, sending forms home, having parents sign forms at drop-off, talking to the school nurse. We needed them all to reach as many children as we could.”

In just one week in December 2021, Nationwide Children’s staff visited 79 Columbus City Schools’ buildings to run vaccine clinics. Overall, Nationwide Children’s has vaccinated approximately 11,000 students since April in school-based vaccine clinics in central Ohio.

A large percentage of those students simply would not have been vaccinated against COVID-19 otherwise, Ray said.

The work isn’t over. Scheduling school-based clinics for second shots or boosters has been difficult so far in 2022, because a new surge in COVID-19 cases has forced many students to return to virtual learning.

Care Connection also hopes to reach another group of families and children: those who are still on the fence about receiving the vaccine, said Ray. The program plans to convene focus groups of those families, to better understand their concerns. The medical and scientific evidence is clear that vaccination against COVID-19 is safe and effective, and Care Connection wants to learn how they can better communicate with families who are unsure.

“The situation is changing all the time, and we continue to change and pivot so that we can help care for as many students as possible,” Ray said.