Special Projects Fund

Grantee Name

New York University, Student Health Center

Funding Area

Special Projects Fund

Publication Date

May 2021

Grant Amount

$309,913

Grant Date:

December 2015 - April 2018

Approximately 1.3 million students attend one of the 271 institutions of higher education in New York State.

Though often overlooked, a large proportion of these students are unvaccinated for preventable diseases, such as influenza, hepatitis B, and meningitis. A range of factors lead to the potential of disease outbreaks among college campuses, such as a lack of regular preventive visits, financial barriers, misperceptions of risk, and no uniform method of vaccination record-keeping. Although many students enter college missing age-indicated vaccinations, the campus environment provides an opportunity to provide annual, indicated, and catch-up vaccinations. NYSHealth awarded the Student Health Center at New York University (NYU) a grant to implement a peer-based learning network focused on raising vaccination rates.

Outcomes and Lessons Learned

  • Established the first learning collaborative to engage colleges in increasing vaccination rates among their student bodies.
  • Convened college student health centers to develop sustainable, system-level improvements to increase immunization rates and learn and apply quality improvement methods.
  • Enrolled 18 institutions of higher education—including public, private, and community colleges statewide—representing 486,432 students. Of these schools, 10 institutions provided regular submission of data, which showed increased vaccination rates in: Influenza Vaccine, 5% overall increase; Tdap Booster, 12% overall increase; HPV Series Completion, 72% overall increase.
  • Established successful strategies to increase vaccination rates in schools that participated in the learning collaborative, such as:
    • Redesigning students’ pre-matriculation vaccination history form to include all vaccines recommended by the national Advisory Committee on Immunization Practices, not just State-mandated ones;
    • Holding HPV vaccination clinic events;
    • Deploying direct-to-student messaging (e.g., simple initiatives like having staff wear “Get Your Flu Shot Now” buttons in the health clinic); and
    • Leveraging nontraditional touch points on campus, such as mental health or social service counselors, for vaccine referrals.

Although the progress achieved by participating colleges generally exceeded NYU’s predictions, the actual scale of the work was smaller than originally projected. NYU set out to engage a diverse set of 60–90 institutions of higher education, representing 600,000 college students, but fell short of its goal. Challenges included lack of support from institutional leadership; student health centers considering nonmandated vaccines as out-of-scope; perceived lack of capacity among health center staff to take on more work; and feedback from some staff who said they were already performing this work. There were also unanticipated structural challenges, such as issues with electronic medical record compatibility among different colleges in the collaborative and difficulty in stocking or administering vaccines. It is also difficult to track whether colleges continued using the learning collaborative’s strategies beyond the grant. NYU had planned to develop an implementation toolkit on best practices for increasing vaccinations among college students across the State, but because of low enrollment in the learning collaborative, it altered course and did not create the toolkit.

NYU found that many colleges perceived New York State’s vaccination requirements to be resource intensive, even though the project was designed to streamline the vaccination process for low-resourced, nonvaccinating institutions without needing new resources. It also found that leadership support was key to college participation. Many leaders in higher education do not have a health care background, and clearer communication was needed to convince these leaders of the project’s importance and feasibility. NYU identified that building relationships with professional associations that support higher education administrators would play an important role in successfully implementing this type of work.

This project was the first of its kind in its effort to improve vaccination rates on college campuses, beyond State policies pertaining to college matriculation. Ultimately, the project goals were overly ambitious because NYU did not fully realize what was needed to achieve a high-level of participation among colleges. Valuable lessons were learned for organizations looking to undertake large-scale, systems-level change in increasing student vaccinations. These lessons are increasingly relevant as colleges across the country start requiring students to have a COVID-19 vaccine to attend classes. In hindsight, it might have been wise to use a pilot with a smaller cohort to test the feasibility of a promising idea.

Co-Funding and Additional Funds Leveraged: N/A