I will be presenting this session at the National Association of School Nurses (NASN) 2026 Conference on Tuesday, June 30, from 1:00 PM–3:00 PM. This presentation highlights a practical, school-based strategy designed to address a persistent challenge faced by many districts: students who are delinquent in required immunizations.
In Prince George’s County Public Schools, maintaining immunization compliance is essential for protecting student health and preventing outbreaks of vaccine-preventable diseases. When district immunization data were reviewed, seventh-grade students emerged as the most frequently noncompliant group, particularly for the tetanus, diphtheria, and acellular pertussis (Tdap) booster and the meningococcal conjugate (MCV4) vaccine. Importantly, existing research suggests that vaccine delinquency is rarely rooted in refusal. Instead, it is more often associated with barriers such as transportation difficulties, cost concerns, scheduling conflicts, and limited access to healthcare services.
To reduce these barriers, our team implemented mobile immunization clinics directly on school campuses. By bringing vaccines to students, we eliminated many logistical challenges and improved access to preventive care. Research supports this approach, demonstrating that mobile clinics are effective in reaching populations with limited access to healthcare and in improving overall vaccination coverage (Leibowitz et al., 2021).
This initiative aligns closely with the NASN School Nursing Practice Framework, particularly the domains of care coordination and community/public health. School nurses played a central role in immunization surveillance, family outreach, education, and follow-up, reinforcing their leadership within coordinated school health programs (National Association of School Nurses, 2024).
Additionally, the program supports Healthy People 2030 objectives by increasing adolescent vaccination rates and reducing preventable disease outbreaks (Office of Disease Prevention and Health Promotion, 2020). Addressing vaccine hesitancy through respectful, culturally responsive communication was also critical, as trust and structural barriers continue to influence vaccination decisions (Brumbaugh et al., 2025; Richman et al., 2025).
This work demonstrates that when schools meet families where they are, immunization compliance improves and, more importantly, trust is strengthened, equity is advanced, and safer learning environments are created for all students.