The Florida Department of Health in Baker County is a small organization in a rural community serving a population of 28,000. Baker County has a population that is 82.5% white, 13.6% black, and 4% other or mixed race. 9.5% of families are under 100% of the base poverty level. In Baker County, close relationships are had by the health department with community partners including the local school district, sheriff's office, and county and city officials. The Baker County School District and the Florida Department of Health in Baker County (DOH-Baker) partner to provide school health services including addressing compliance for school health immunizations. For years, the school health program has faced challenges achieving compliance with adolescent immunizations, specifically the seventh grade Tetanus, Diptheria, and Pertussis (TDAP) vaccine. In Florida, this vaccine is required prior to entry into the seventh grade for public and private schools. Each year, fliers, calls, and multiple reminders are made to students and parents in the fifth and sixth grade to prepare for this requirement and each year on the first day of school many students are sent home due to noncompliance. With a total school district population of 5000, and a seventh grade population of nearly three hundred, having fifty students sent home the first day of school for noncompliance is a significant issue for this community. This requires parents leave work to pickup their student and the student cannot return until proof of compliance is received by the school's guidance office.
In 2017, it was noted by the school health coordinator at the health department at the time, that the process currently implemented was not working and a meeting was held with the local school health liaison at the school district to discuss. Out of this meeting came a plan to prevent students from receiving their schedule until compliance was achieved. It is important to note that in Baker County there are no large media outlets thus most news and information comes from the local newspaper, The Baker County Press. Each year a special edition is printed the week before school returns to session that lists open house events and students classroom assignment. This is something that families look forward to each year. It was determined that unless the student is compliant with required school immunizations their classroom assignment would be withheld from the paper. Of course, this causes parents to call the school to determine why their child's name was withheld and they are told about their child's noncompliance for immunizations. A practice was also implemented that if a student shows up for open house, their schedule will be withheld and they will be sent to the guidance office to discuss their immunization noncompliance. The first year that this was implemented it was a great success and the number of students arriving to the first day of school in noncompliant status was greatly reduced from fifty down to ten. However, one issue that was noticed was parents having a difficult time getting their child into get the vaccines prior to the first day of school. In Baker County, the paper comes out on Wednesday, Open House is Thursday, and school starts Monday. This does not leave much time for parents to achieve compliance before the first day of school.
To this end, in subsequent years, clinics were held during open house and the morning of the first day of school at DOH-Baker allowing for walk-in immunizations for school aged children. This allows parents, once notified of their student's noncompliance, to take them straight over to the health department to receive their vaccine and shot record and return back to the school to receive their schedule or attend school. With the addition of this practice, in 2020 and 2021 only two to three students were still found to be noncompliant on the first day of school.
This achievement was made through collaboration with multiple community partners including the Baker County School District and the Baker County Press. Without their involvement this practice could not have been successfully implemented. This practice makes immunizations available to all students at a location that is easily accessible and close to the school and allows parents to have minimal disruption to their work day. It keeps students in school where they can learn and grow into successful adults in our community and reduces public health impacts by achieving increased immunity against vaccine preventable diseases. This practice has now been successfully implemented for four years and improved upon each year. The final objective is to eventually reach 100% compliance with required school immunizations before the first day of school.