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All for Them team publishes paper on lessons learned over project’s course

Published: May 26, 2023

Efrat Gabay, MPH, senior program manager of All for Them, talks with middle school students during a recent vaccination clinic in Houston.
Efrat Gabay, MPH, senior program manager of All for Them, talks with middle school students during a recent vaccination clinic in Houston.

Higher-level champions within schools. Known and trusted health organizations. Tailored outreach efforts that meet families and communities where they are.

These are just a few key ingredients to the recipe of success that All for Them created while coordinating hundreds of free, school-based vaccination clinics for Texas students.

All for Them, an initiative launched in 2017 and run by UTHealth Houston School of Public Health, has coordinated free vaccination clinics at middle and high schools in six districts across the state: Aldine ISD, Crowley ISD, Fort Worth ISD, Goose Creek CISD, Houston ISD, and Spring ISD.

The All for Them team recently published the lessons they learned from the experience in the journal Vaccines.

“We’ve been bringing All for Them to public schools for six years now, and it was important to let others – both project stakeholders and those interested in implementing similar school-based vaccination initiatives – know what we have learned and how we have made changes over the years,” said Efrat Gabay, MPH, senior program manager of All for Them.

Since 2017, more than 6,000 students have received at least one vaccine during the clinics. Over 4,000 of those students received the HPV vaccine. Of those parents whose youths needed an HPV vaccine dose, All for Them achieved a 96% acceptance rate, a significant accomplishment of the project’s approach. Most of the students who did not receive the HPV vaccine were already up to date on the series, not yet due for the next dose at the time of the clinic, or not eligible for the vaccine.

“We want people to understand that using the All for Them approach is doable, but you have to be prepared across all of the areas we outlined in the paper to maximize success,” Gabay said.

The All for Them team identified key lessons within six domains:

  • Strong champion, in which a district-level leader advocates for the vaccination program
  • School-level support, in which campus leaders coordinate with and support the program
  • Marketing, including approaches tailored to schools, communities, and audiences
  • Mobile clinic collaboration, including partnering with trusted organizations in the community
  • Community presence, in which All for Them team members attend health fairs and other public events to connect with families
  • Crisis management, including the need for flexibility and innovation to cope with natural disasters and pandemics

“Based on our experience with working with schools, we knew that the project would have to be flexible to individual campuses’ needs,” said Paula Cuccaro, PhD, All for Them principal investigator and UTHealth Houston School of Public Health assistant professor. “However, we did not necessarily anticipate the drastic adaptations we might need to make to the program during major upheavals, such as the COVID-19 pandemic. The importance of preparedness truly cannot be overstated.”

The All for Them team learned to adapt as different challenges arose. When those changes led to success, the team added the strategies to their toolbox.

“Implementing a multi-component strategy at different levels is necessary,” Cuccaro said. “While some activities don’t necessarily seem as critical at face value, they all play an important role. And we want people to keep in mind that schools are an excellent alternative setting to provide immunizations such as the HPV vaccine.”

Overall, the All for Them team hopes that other organizations, projects, and communities can take what the team has outlined in the paper and run with it, bringing more life-saving immunizations to the communities that need them the most.

“We want others to benefit from our experience,” Cuccaro said. “Anyone interested in implementing All for Them or developing a similar program is welcome to reach out to us for more information.”

Contact the All for Them team at AllForThem@uth.tmc.edu or 866-255-1811. Learn more about All for Them at allforthemvaccines.com. Follow the project on Facebook and Instagram @AllForThemVaccines and Twitter @AllVaccines.

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