Immunization, Vaccines and Biologicals

School-based immunization

Vaccination in schools

One of the objectives of the Global Vaccine Action Plan (GVAP) is to equitably extend the benefits of immunization to all children, adolescents and adults. School-based immunization is a strategy for reaching older children and adolescents with vaccination services. With the availability of newer vaccines (e.g. human papillomavirus (HPV)) and greater attention to providing booster doses of routine vaccines to older children (e.g. DTP, 2nd dose of measles), there is a growing interest in using schools as a platform for immunization. With increases in school enrolment rates, particularly in low income countries, the school immunization strategy has become even more promising.

Documenting country experiences

WHO and partners are documenting experiences from several countries with existing school-based immunization programmes. To date, the programmes in Indonesia, Malaysia, Sri Lanka and Tunisia have been documented. These countries have well-established nationwide school immunization programmes that have been implemented for decades. Other countries contemplating the introduction of similar strategies can look to these case studies for guidance on designing, organizing and implementing such programmes.

Country case studies on school-based immunization

Assessing the country’s capacity to vaccinate in schools

Before implementing school vaccination programmes, countries should assess the capacity of their school and health systems to support such programmes. Undertaking a readiness assessment will aid countries in their decision-making and planning, but can also be used by countries wishing to improve the performance of their existing school vaccination activities. WHO has developed an assessment tool to assist countries to identify strengths and weaknesses in the current school environment to consider introduction of vaccines through schools.

WHO and UNESCO have also developed country profiles for GAVI countries to help identify which school class/grade to target for HPV vaccine introduction.

WHO-UNESCO country reports on age distribution and school attendance of girls aged 9-13 years

Opportunities for integrating vaccines with other school health interventions

School health settings provide good opportunities to integrate vaccine delivery with other health interventions aimed at reducing vaccine preventable diseases and improving population health. For example, HPV vaccination can be linked with health information and warnings against tobacco use, as an intervention aimed at primary prevention of cervical cancer. In addition, linking HPV vaccine delivery with other health interventions for school-age children like deworming can increase coverage of these interventions and reduce cost of delivery.

The WHO Global School Health Policies and Programmes Survey (G-SHPPS) allows countries to assess the school health environment in schools and the coverage of health interventions being delivered at school, including vaccines.