School immunizations a labour of love for Public Health team

Photo of some of the dedicated members of the Central Zone School Immunization team.
Photo of some of the dedicated members of the Central Zone School Immunization team.

Immunizations are the cornerstone of a strong provincial Public Health system. In Nova Scotia, routine vaccinations are publicly funded for people at all stages of life, preventing illnesses that can cause serious illness or death in the most severe cases.

Nova Scotia Health’s Public Health program supports immunizations in many ways, including the School Immunization Program. From September to June, clinics are set up in schools across the province, and students in grade seven are given access to four publicly funded vaccines:

1. Hepatitis B
2. Human Papillomavirus (HPV 9)
3. Meningococcal Quadrivalent (Groups A, C, Y & W 135)
4. Tetanus, Diphtheria, and Acellular Pertussis (Tdap)

The School Immunization Program is part of the Health Protection team under Public Health, and it’s a big undertaking that begins well before any vaccines go in arms. The team of nurses who organize the clinics work closely with the Regional Centres for Education (RCEs) and Conseil scolaire acadien provincial (CSAP) to schedule clinics, and then go on to order vaccines, supplies and coordinate staffing. There is also significant preliminary work supporting students and families, including answering questions and securing consents.

“There’s an amount of education and support nurses provide to the families that is not seen,” explained Katherine Malec Health Protection Manager for Central Zone. “Our goal is safety and efficiency at the clinics, but not everyone is ready to jump into the chair and roll up their sleeves. There is a tremendous amount of support in providing reassurance and education to these students to help them with their immunizations.”

The School Immunization Program has been a staple of Public Health for a long time and is, in many ways, a well-oiled machine. Even so, Malec acknowledges that each student is different, and outside pressures are always part of the job, so being nimble is important.

“We have processes in place, but very rarely is it ever just a linear path. Each clinic presents its own unique circumstances.”

The team’s skill for finding unique solutions was put to the test in 2020. When schools shut down in March, the spring program was halted, leaving thousands of students without their full course of vaccinations. Those leading the program came up with an ambitious solution.

“Our manager put forth a proposal to the province to do summer clinics over a three-week period,” said Jennifer Turcot, a Charge Nurse who supports the School Immunization Program in Central Zone. “There was a lot of skepticism around whether we could do it, especially during COVID-19.”

Despite that uncertainty, the team was given permission to go ahead with summer clinics, and they did not disappoint. Incredibly, they managed to immunize 70% of students in just over three weeks – a great success.

Even after such a big push, there was little time for the team to catch their breath. With students returning to schools in the fall, they had to reimagine how they would provide immunizations on school campuses under the new pandemic restrictions. Students now had to be physically distanced, and classes would be brought down one at a time. Every student would be screened before going into the clinic, and students who were symptomatic for COVID-19 would be given personal protective equipment to prevent the spread of illness. To add an extra wrinkle, the additional 30% of students from the previous cohort still needed vaccines and would be getting them during the fall semester.

Even with all those hurdles, every student who wanted to be vaccinated was accommodated by the end of 2020 – just in time for a new COVID-19 mass immunization campaign to begin.

When the COVID-19 vaccine became available, it was all-hands-on-deck to manage the rollout, and school immunizers were re-deployed to support. The difficult decision was made to hold off on school vaccines again in spring 2021. Those vaccinations would have to be completed the next school year.

In fall 2021, a double cohort of grade 7 and 8 students was immunized – 10,000 kids in Central Zone alone.

“It’s difficult getting our regular year done, so to double that up with a team that has been through turmoil like everyone else, it’s very impressive,” said Malec. “Our team was exactly the way every other health care worker was during that time: exhausted, rerouted into other roles. I think the passion for their program was really demonstrated by making that happen.”

Turcot added, “It takes a team. Everybody must work together to do it right, because if you don't, it's not going to work. Everybody has to be willing to work harder, longer. We all gave up a lot, and I'm really proud of the team.”

After two tumultuous school years, in 2022 the School Immunization Program was finally able to return to its regular programming. Now they’re using the lessons of the past few years to plan ahead, as they re-establish relationships with RCEs and CSAP and remind students and parents of the importance of routine vaccinations.

“I'm very cognizant of vaccine fatigue and am concerned about the impact of that, so we’re focused on advocating for the importance of the publicly funded vaccines,” said Turcot.

Although the School Immunization Program focuses on students in the seventh grade, those vaccines are available for free to anyone up to and including age 18. Public Health routinely offers catch-up vaccine clinics and welcomes referrals from health care and community partners.

“We don't want to have any missed opportunities. The door is not closed, we keep that line of communication open,” said Malec.

Parents and students are encouraged to call Public Health if they have questions about any of the vaccines offered as part of the School Immunization Program, or any other publicly funded vaccine. To learn more, contact your local Public Health office.