We at the NH Immunization Program (NHIP) have developed a School-Based Influenza Clinic Toolkit for school nurses.  This toolkit is meant to use if you, as a school nurse, decide to hold a flu clinic in your school.  It is not all-inclusive but does contain information and forms that can be used for clinic set up, informing parents and other aspects of organizing a school-based flu clinic. 

We hope you will partner with the VNA in your area, a private company or your medical community to administer the vaccine and provide medical management.  We anticipate the school nurse will be the organizer of the clinic, utilizing community partners. 

Two workshops for NH school nurses were provided by the New Hampshire Immunization Program in July 2009. The workshop information is provided here for your reference.

TABLE OF CONTENTS (2 pages)

I.  Getting Started

1. Timeline for Planning School-Based Clinic (3 pages)
2. Suggested Supplies for Pediatric and Adult Immunization Clinic (2 pages)
3. Sample MOU for School-Based Influenza Clinic (2 pages)
4. List of Interested NH VNA/Home Health Providers (1 page)

Note:    Many Toolkit resources are publications, used with permission, from national immunization partners, especially the Immunization Action Coalition (IAC).  In order to assure that the Toolkit contains the most current versions of the publications, we have provided these resources as links to the documents on their home website, rather than as PDFs.  These links will take you to the partner's website, and away from the DHHS website, so you will need to use your browser's Back Arrow button to return to the Toolkit on the DHHS website.

II.  Medical Management

1. Standing Orders for Administering Influenza Vaccines to Children & Adolescents
2. Standing Orders for Administering Influenza Vaccines to Adults
3. Medical Management of Vaccine Reactions in Children and Teens
4. Medical Management of Vaccine Reactions in Adult Patients
5. It's Federal Law! (providing VIS statement)
6. VIS Statement: Live Intranasal Influenza Vaccine
7. VIS statement: Inactivated Influenza Vaccine
8. Notification of Vaccination Letter
9. Screening Questionnaire for Injectable Influenza Vaccination (for day of clinic)
10. Screening Questionnaire for Intranasal Influenza Vaccination
11. VAERS pamphlet  and VAERS form
12. Clinic Flow Plan Diagrams from pkids.org – See pages 13-15

III.  Parent Information

1. Don't take chances with your family's health – make sure you all get vaccinated against influenza every year!
2. The Flu, A Guide for Parents (2 pages)
3. Screening Questionnaire for Child and Teen Immunization
4. Consent Form and Vaccine Administration Report (1 page)
5. What Flu vaccine your child received today: Notice to Parents (1 page)
6. After the Shots: If Your Child Has Discomfort    
7. Stay Healthy This Season! Free Flu Vaccination at School!: Template of newsletter article to customize (1 page)

IV.  Storage and Handling

1. Vaccine Handling Tips 
2. Checklist for Safe Vaccine Handling and Storage
3. Temperature Logs in Celsius and Fahrenheit (5 pages)
4. Emergency Response Worksheet
5. Vaccine Handling, Storage, and Transport (5 pages)

V.  School Immunization Requirements

1. Letter to School Nurses re: 2009-2010 School Year Requirements-January 30, 2009 (2 pages)
2. Requirements for the 2009/2010 School Year (4 pages)
3. Memo to School Nurses & Principals re: School Survey-July 15, 2009 (1 page)
4. Sample School Survey (1 page)

VI.   Information on Seasonal Influenza, H1N1, and Communicable Disease Reporting

1. Communicable Disease Control Section Pamphlet (2 pages)
2. NH Reportable Disease List (1 page)
3. How to Stay Healthy and Avoid the H1N1 Swine Flu–Flyer (1 page)
4. Facts About H1N1 Flu (Swine Flu) (1 page)
5. H1N1 Influenza (Swine Influenza) Frequently Asked Questions (3 pages)
6. Link to NH DHHS H1N1 website