Parent attitudes about adolescent school-located vaccination and billing

J Adolesc Health. 2014 Nov;55(5):665-71. doi: 10.1016/j.jadohealth.2014.05.015. Epub 2014 Jul 15.


Purpose: School-located vaccination programs may need to bill health insurance to be sustainable. This mixed methods study assessed parent attitudes about school-located vaccination and billing.

Methods: Seven public schools in Denver, Colorado, participated in a school-located adolescent vaccination program that billed students' insurance. From April through June 2010, a survey was administered to parents of 1,000 randomly selected sixth to eighth grade students in these schools. In March and April 2011, focus groups were conducted with a sample of parents of adolescents attending these schools to further explore and help explain patterns emergent in the survey data.

Results: Survey response rate was 66%. Among survey respondents, 56% strongly supported and 29% somewhat supported school-located vaccination. Forty-two percent reported concern about receiving a bill if their child participated in a school-located vaccination program that billed insurance, and 23% did not want to provide insurance information to the school. Four focus groups were conducted with English-speaking (n = 17) and Spanish-speaking (n = 14) parents. Focus group participants indicated strong support for school-located vaccination, emphasizing the convenience of the program for both parents and adolescents. These parents also appreciated the affordability of the program and reported feeling comfortable with in-school vaccination delivery. Very few participants indicated concerns about providing health insurance information to the school, but some expressed concern about potential record scatter.

Conclusions: Although some parents expressed concerns about billing health insurance for school-located vaccination, most parents indicated strong support for school-located vaccination.

Keywords: Adolescent; Billing; Mixed methods; Parent attitudes; School-located vaccination; Vaccine.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Attitude to Health*
  • Colorado
  • Female
  • Focus Groups
  • Humans
  • Immunization Programs / economics
  • Immunization Programs / organization & administration*
  • Male
  • Middle Aged
  • Parental Consent
  • Parents*
  • Patient Acceptance of Health Care / statistics & numerical data
  • School Health Services / economics
  • School Health Services / organization & administration*
  • Vaccines / administration & dosage*
  • Vaccines / economics


  • Vaccines