Testing and Vaccinations > COVID-19 Vaccine Administration in Schools
According to the CDC, the ultimate public health goal of the US COVID-19 vaccination program is to make COVID-19 vaccine available to all who want to be vaccinated. School-located vaccine clinics (SLVC) at school play an important role in improving student’s vaccination coverage rates by improving student and community access and reducing parents’ need for time away from work.
The school nurse can play a critical role in advocating for and educating the school community, assisting with logistics planning and implementation, and understanding both the needs of the community and the school.
Key Considerations:
- Determine if school leadership supports COVID-19 vaccine administration in the school system and consider options for vaccine vendor partnerships in the community.
- Determine legal implications for the vaccine clinic(s). School nurses and licensed volunteers participating in the vaccine clinic are protected under the Public Readiness and Emergency Preparedness Act (PREP Act) provides immunity to qualified individuals.
- Establish a process for obtaining parent consent for vaccine administration. Parents may not be required to be present during vaccine administration based on state and territorial regulations.
- Establish communication and coordination with state and local public health departments, jurisdictional immunization programs, and emergency management to help ensure a successful vaccination clinic. Medical orders and emergency response medications are included in the planning with vaccine providers.
- Provide education about the coronavirus vaccine prior to the vaccine clinic (e.g. electronically or during registration) for the school community including students, parents, and staff.
- Plan parent outreach especially if there is a high level of reluctance or hesitancy toward vaccination in the community.
- Determine best location for a clinic using the following guidance:
- Ability to accommodate students most commonly via walk-through, drive-up, or mobile clinic
- Ability to maintain appropriate vaccine cold chain, storage and monitoring
- Accessible restrooms
- Determine if the location meets the space requirements for a clinic.
- Accessible areas with adequate space and seating
- Adequate space for entry and exit points, including the one-way clinic flow
- Adequate heating and cooling
- Adequate lighting
- Capacity to accommodate physical distancing of staff and students as needed
- Ability to accommodate students’ needs and develop plans for compliance with Americans with Disabilities Act (ADA) standards as needed (e.g. students with disabilities and mobility issues).
- Enough power outlets and electrical capacity for clinic needs, including portable refrigerators for vaccine storage and computers, if applicable
- Space for clinic functions such as screening, registration, vaccine storage and preparation, vaccination, waiting areas to monitor for adverse reactions after vaccination, and emergency care
- Determine if additional equipment is needed including a stable power source, lighting, emergency back-up power, vaccine storage units, and robust communications capabilities (e.g. internet connectivity), secure area with controlled access for storing vaccine (in appropriate cold chain equipment), ancillary supplies including PPE, vaccination cards, IT equipment, and other supplies/equipment should be identified.
- Determine staffing (non-clinical and clinical staff) that will be needed. Key roles may include pre-entrance screeners, greeters/registration staff, medical screeners, vaccine inventory and storage managers, vaccine preparers, vaccinators, crowd management, runners, data input/management staff, post-vaccination observers (including clinical personnel), and exit managers. State and Territorial agencies may be able to assist with volunteers through a medical reserve corp.
- Provide staff with comprehensive, competency-based training on vaccine administration policies and procedures training for the smooth operation of a vaccination clinic. Everyone working in a clinic must know their role, their job duties, how their role relates to others, and be qualified and trained to carry out their responsibilities and reduce liability.
- Communicate about the vaccination clinic to the school community using existing resources, social media, and local media. Establish a communication plan to include announcing the date of the clinic, location within the school, description of who is eligible to be vaccinated, and process for student registration.
- Consider the need for translation services for non-english speaking parents.
- Develop and communicate the vaccination pre registration process for students to be completed by parents/guardians.
- Workflow and/or separate stations with personnel conducting various functions need to be planned in detail. Based on the population served, bilingual staff or translation services may always be needed at each station. Stations can include:
- Student pre-entry to support physical distancing
- Greeter for onsite registration
- Registration
- Medical screeners: If Registration staff note that a parent or student has reported possible contraindication, they will be referred to their primary care provider for further guidance with receiving the coronavirus vaccine.
- Student waiting areas with ability to accommodate physical distancing
- Vaccination administration stations
- Post-vaccination observation stations
- CDC currently recommends the following observation periods after vaccination
- 30 minutes for: People with a history of an immediate allergic reaction of any severity to another vaccine or injectable therapy. people with a contraindication to a different type of COVID-19 vaccine, and people with a history of anaphylaxis due to any cause.
- 15 minutes for: All other people.
*This area must be staffed by trained clinicians who can recognize early symptoms of anaphylaxis.
*Designate an area that is sectioned off and screened from view and available to give emergency care should an individual experience an adverse or anaphylactic reaction after vaccination.
- Determine the amount of vaccine doses and ancillary supplies needed during the vaccination clinic.
- Procedures to address how medical hazardous waste will be collected and disposed of during and after each day of operations, including having ample “sharps” containers to collect used syringes and vials.
- Procedures to address vaccine reporting requirements, Vaccine administration tracking and vaccine inventory reporting to VaccineFinder.
- Collaborate with IT to set up and problem solve access issues and HIPPA/FERPA compliance with data requirements.
NASN Resources
COVID-19 Prevention for K-12 Schools Part 3: Focusing School Located Vaccination on Health Equity | 1.25 NCPD Continuing Nursing Education contact hours
School-located Vaccination Clinics | NASN School Nurse Supplement
School-located Vaccination Position Statement
School-Located Vaccination: School Nursing Planning Checklist | NASN & Association of Immunization Managers
School-Located Vaccination: Clinics in the Context of COVID-19 - A tips sheet for immunization programs | NASN & Association of Immunization Managers
School-Located Vaccination Clinics for COVID-19 and Influenza: Insights from virtual roundtable discussions with school nurses and state immunization program managers | Roundtable Report
School-Located Vaccination Clinics: Insight into state and local level practices, policies and lessons learned from providing COVID-19 and routine vaccinations in schools | Environmental Scan Report
Strategies to Support the Return to School for School-aged Children Recording from Webinar hosted on 07/27/2020
CDC Resources
Vaccine for COVID-19
Building Confidence in COVID-19 Vaccines
12 COVID-19 Strategies for Your Community
COVID-19 Vaccine for Children
Considerations for Planning School-Located Vaccine Clinics
COVID-19 Vaccine Toolkit for Staff in School Settings and Childcare Programs
Different COVID-19 Vaccines
Guidance for Planning Vaccine Clinics Held at Satellite, Temporary, or Off Site Locations
Vaccine Recipient Education: Quick references for COVID-19 vaccinators to give people who want more information
Vaccine Storage and Handling Toolkit
What to Consider When Planning to Operate a COVID-19 Vaccine Clinic
COVID-19 Vaccination Clinical & Professional Resources
Other Resources
COVID-19 Action Initiative Virtual Roundtable: Increasing Vaccination Rates for Youth and Adolescents
Crucial Vaccination Conversations: A Roadmap to Engage Women and their Communities | Society for Women’s Health Research
COVID-19 Vaccines | FDA
PREP Act Immunity from Liability for COVID-19 Vaccinators | U.S. Department of Health & Human Services Office of Assistant Secretary for Preparedness and Response (ASPR)
COVID-19 Vaccines in Children and Adolescents | Official Journal of the American Academy of Pediatrics
Managing a COVID-19 Vaccine Clinic at a School Site | Kaiser Permanente Thriving Schools
COVID Vaccine Facts for Nurses | The American Nurses Association (ANA)