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BACKGROUND: Only half of US schoolchildren receive influenza vaccine. School‐located influenza vaccination (SLIV) might raise vaccination rates but conducting flu vaccine clinics at schools is challenging to implement. We compared 2 school‐based programs designed to raise influenza vaccination rates: parent reminder/educational messages sent to parents from schools which is a low‐intensity intervention vs the combination of reminder/educational messages plus SLIV clinics which is a high‐intensity intervention. METHODS: We assigned 36 schools (6 school districts, 2 per group) to 3 groups: (1) control, ie, no SLIV and no parent reminder/education, (2) parent reminder/education emailed by schools, and (3) parent reminder/education plus SLIV clinics. Some schools had SLIV clinics in prior years. Health department nurses conducted SLIV clinics. RESULTS: Among 24,832 children at 36 schools, vaccination rates were control (51.3%), parent reminder/education‐only (41.2%), and reminder/education + SLIV (58.7%). On multivariate analyses which controlled for vaccination in prior seasons, children in reminder/education + SLIV schools had higher vaccination rates (OR 1.27, 95% CI 1.10‐1.47), but children in reminder/education‐only schools had lower rates (OR 0.87, 95% CI 0.75‐1.00) than children in control schools. CONCLUSIONS: Parent reminder/education combined with SLIV clinics raise vaccination rates, but parent reminder/education alone does not. [ABSTRACT FROM AUTHOR]

Purpose We aimed to evaluate the effect of school-located influenza vaccination (SLIV) on adolescents' influenza vaccination rates. Methods In 2015–2016, we performed a cluster-randomized trial of adolescent SLIV in middle/high schools. We selected 10 pairs of schools (identical grades within pairs) and randomly allocated schools within pairs to SLIV or usual care control. At eight suburban SLIV schools, we sent parents e-mail notifications about upcoming SLIV clinics and promoted online immunization consent. At two urban SLIV schools, we sent parents (via student backpack fliers) paper immunization consent forms and information about SLIV. E-mails were unavailable at these schools. Local health department nurses administered nasal or injectable influenza vaccine at dedicated SLIV clinics and billed insurers. We compared influenza vaccination rates at SLIV versus control schools using school directories to identify the student sample in each school. We used the state immunization registry to determine receipt of influenza vaccination. Results The final sample comprised 17,650 students enrolled in the 20 schools. Adolescents at suburban SLIV schools had higher overall influenza vaccination rates than did adolescents at control schools (51% vs. 46%, p  < .001; adjusted odds ratio = 1.27, 95% confidence interval 1.18–1.38, controlling for vaccination during the prior two seasons). No effect of SLIV was noted among urbanschools on multivariate analysis. SLIV did not substitute for vaccinations in primary care or other settings; in suburban settings, SLIV was associated with increased vaccinations in primary care or other settings (adjusted odds ratio = 1.10, 95% confidence interval 1.02–1.19). Conclusions SLIV in this community increased influenza vaccination rates among adolescents attending suburban schools. [ABSTRACT FROM AUTHOR]