Significant progress has been achieved in the social, economic, educational, and health status of many populations. Compared with previous generations, the educational status of those born after 1990 has improved, as reflected in higher rates of school enrollment, especially in low- and middle-income countries (LMICs) (UNESCO 2014). Countries have started to expand their immunization programs beyond infants to young children, adolescents, and adults, with the goal of preventing, controlling, and where possible, eliminating vaccine-preventable diseases (WHO 2013a).
The combination of increased school attendance and expanded target populations for vaccines has created a rich opportunity for exploring vaccine delivery in schools (annex 15A, figure 15A.1). Meningitis, measles, hepatitis B, tetanus toxoid (TT), and human papillomavirus (HPV) are examples of vaccines offered in schools, either as routine primary or booster vaccinations or through campaigns for catch-up strategies or disease control (Grabowsky and others 2005; Mackroth and others 2010; WHO 2012a). These vaccines have demonstrated efficacy in preventing significant morbidity and mortality among school-age children, adolescents, and adults (Mehlhorn, Balcer, and Sucher 2006; WHO 2009). Understanding country experiences with the operational and logistical factors that have enabled successful delivery of vaccines through school-based programs—and the challenges encountered—can provide salient lessons for other countries, irrespective of income status. This chapter highlights the promise of school-based delivery of vaccines in LMICs, using the experience of TT and HPV vaccine delivery as examples. Definitions of age groupings and age-specific terminology used in this volume can be found in chapter 1 (Bundy and others 2017).
© 2017 International Bank for Reconstruction and Development / The World Bank.