Vax Champions: NASN's Initiative for COVID-19 & School Vaccination Confidence and Equity

BY Deborah D’Souza-Vazirani

The COVID-19 vaccine was developed and administered to millions of Americans in record time and continues to help prevent severe illness and hospitalization from COVID-19. Although over 70 percent of adults nationally have received at least one dose of a COVID-19 vaccine, only 39 percent of children ages 5 to 11 have received at least one dose of the vaccine. Recognizing the key role that schools, school nurses (SNs), and community-based organizations (CBOs) played in the pandemic response and promotion of health equity among children, the National Association of School Nurses (NASN), with generous funding from Kaiser Permanente (KP) developed, and implemented the Champions for School Health (CSH) grant initiative. This project funded SNs, and CBOs that are working to increase pediatric vaccine access, and confidence among underserved populations in KP’s footprint: California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, and the District of Columbia.

NASN gave 54 Implementation Grants in two funding cycles in 2022 in all KP markets of which 30 grants went to SNs. Via the two funding cycles, NASN has worked with twenty-two new CBOs based in six KP markets which are small organizations serving mostly immigrant/refugee and ethnically diverse communities in their states. The successful project implementation and the resulting NASN created tools demonstrate NASN’s capacity for future similar projects.

The CSH initiative’s objectives included increasing pediatric COVID-19 vaccine and school-required vaccination confidence and rates for children ages 5 to 11 as well as creating sustainable school-community partnerships that increase health equity. During the planning stage, NASN adhered to key guiding principles focusing on the deepening partnerships between SNs and their surrounding communities, elevating/strengthening the role of SNs, and supporting culturally competent strategies for increasing pediatric vaccine access and uptake. It also aimed to demonstrate the SN in the community as trusted advocates and empower SNs to use the knowledge gained from their projects to implement high-quality, culturally competent school-based health services beyond the COVID-19 response.

First, NASN met with KP leaders, SN state leadership and potential partner organizations in the 9 KP markets to promote the project, and to learn from their prior experience in providing or receiving grants. NASN created an online grant application and process based on KP’s eligibility criteria and funding requirements as well as an application review process via an online grant portal. Funding announcements with the application package were rolled out in March 2022 (Phase 1) and August 2022 (Phase 2). The application review committee, made up of NASN experts in school nursing and public health reviewed and evaluated the applications. 27 Phase 1 grants distributed ranged from $5,000 to $10,000 and projects had to be completed no later than August 2022. In Phase 2, NASN funded grantees (27 grantees) at higher dollar amounts (up to $30,000). NASN also selected CBOs that demonstrated community connections, with SNs or planned to connect with SNs for their projects.

The NASN CSH team provided technical assistance to grantees to successfully implement their projects. NASN created a dedicated CSH webpage with all project information and reference resources. NASN created an online learning community via its SchoolNurse.net platform and all grantees shared their project pictures and project materials. This has resulted in a rich collection of materials which NASN has shared via a public online library. The learning community connected funded partners to one another for peer learning and curated resources to support culturally appropriate care and patient engagement. NASN staff scheduled individual grantee sessions as well as engaged with grantees via email and telephone which were instrumental in building trust between NASN and grantee, an opportunity to check on the projects’ progress and any challenges, learn more about their work and build strong relationships.

Feedback from the SN grantees resulted in NASN offering a live “Immunization 101” webinar in January 2023 to all SNs which had a SN immunization expert and a pediatrician provide a primer on childhood and adolescent immunizations. NASN collaborated with Frameworks Institute to develop the “Building Family Confidence in the COVID-19 Vaccine” Toolkit (launched in September 2022) which uses a trusted messenger strategy, is based on evidence-based social science research in child vaccination communication, and is free and accessible to any SN and school health services staff and has also been shared with CDC and their partners.

This project recognizes the leadership of SNs in their schools, school districts and communities and their ability to build sustainable partnerships with existing and new CBOs and other partners.

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Article details
Champions for School Health—An NASN Initiative to Increase Vaccine Confidence, Equity, and Uptake in COVID-19 and School-Required Vaccinations: Part 1
Deborah D’Souza-Vazirani, Carol Walsh, Andrea L. Tanner, Elizabeth Clark, A. Renee Griffin & Stephanye White
First Published: April 12, 2023
DOI: 10.1177/1942602X231165693
NASN School Nurse

About the author

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Deborah D’Souza-Vazirani, is the Director of Program Evaluation at the National Association of School Nurses. She is the project manager for the Champions for School Health program, leading the program for the fifteen months. She brings program evaluation and program management expertise to NASN in her current role having over 25 years of program management and program evaluation experience in the public health and health care spheres. Outside work she loves to tool around in her garden learning more about what plants are native to her state.