Increasing Immunization Compliance by Reducing Provisional Admittance

J Sch Nurs. 2016 Aug;32(4):246-57. doi: 10.1177/1059840515622528. Epub 2015 Dec 23.


Students in Vermont with incomplete or undocumented immunization status are provisionally admitted to schools and historically had a calendar year to resolve their immunization status. The process of resolving these students' immunization status was challenging for school nurses. We conducted a school-based quality improvement effort to increase student compliance with Vermont immunization regulations using a collaborative learning approach with public health school liaisons and school nurses from public schools to reduce provisional admittance in 2011-2012. Strategies included using a tracking system, accessing the immunization registry, promoting immunization importance, tracking immunization plans, and working with medical homes to update records. Participating school nurses observed decreases in the number of provisionally admitted students, although this reduction was not significantly different than matched comparison schools. We also found the number of provisionally admitted students fluctuated throughout the year and resolving the immunization status of New Americans and exchange students required special attention. Our approach supports the coordinated school health model and demonstrates the critical role school nurses play in improving population health outcomes.

Keywords: coordinated school health; immunizations; policies and procedures; program development/evaluation; school nursing.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Health Behavior*
  • Humans
  • Immunization / legislation & jurisprudence*
  • Immunization / statistics & numerical data*
  • Immunization Programs / legislation & jurisprudence
  • Immunization Programs / statistics & numerical data*
  • Male
  • School Health Services / legislation & jurisprudence
  • School Health Services / statistics & numerical data*
  • School Nursing
  • Vermont