WHO/IVB/13.

02

School Vaccination
Readiness Assessment Tool

October 2013
The Department of Immunization, Vaccines and Biologicals thanks the GAVI alliance whose financial
support has made the production of this document possible.

This document was published by the Expanded Programme on Immunization (EPI) of the Department of Immunization, Vaccines and Biologicals

Ordering code : WHO/IVB/13.02

Published: October 2013

This publication is available on the Internet at : www.who.int/vaccines-documents/

Copies of this document as well as additional materials on immunization, vaccines and biologicals may be requested from : World Health Organization •
Department of Immunization, Vaccines and Biologicals • CH-1211 Geneva 27 • Switzerland
Fax: + 41 22 791 4227 • Email: vaccines@who.int

© World Health Organization 2013

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Photo : WHO / SEARO /Sanjit Das, WHO /Olivier Asselin, UN Photo/John Isaac, UN Photo/Shareef Sarhan
Cover design: Dalia Lourenço Levin

2
 Acknowledgements

This School Vaccination Readiness Assessment Tool is the result of team work between
Laura Kann of the Division of Adolescent and School Health at the US Centers for Disease
Control and Prevention (CDC) and Susan Wang and Tracey Goodman of the Department of
Immunization, Vaccines & Biologicals at the World Health Organization (WHO).

Special thanks is due to Don Bundy (World Bank), Albert Motivans (Institute for Statistics,
UNESCO), and Liudmila Mosina (WHO European Regional Office) for their review of the tool
and valuable comments.

This work was carried out with the aid of funding from the GAVI Alliance.

3
Table of Contents

Introduction – 4

Purposes – 4

Directions for Use – 5

Module 1: Overall Readiness

Score Card - 8
Scoring Questions and Descriptions – 9
Planning Questions – 13

Module 2: School Readiness

Score Card - 15
Scoring Questions and Descriptions – 16
Planning Questions – 20

Module 3: Implementation Readiness

Score Card - 22
Scoring Questions and Descriptions – 23
Planning Questions – 27

Readiness Assessment Improvement Plan– 29

Bibliography - 31

4
 School Vaccination1
Readiness Assessment Tool

Introduction:
With the availability of human papillomavirus (HPV) vaccines and greater attention to
providing booster and other doses of routine vaccines to older children (for example DTP,
MCV2, etc.), there is growing interest in using schools as a site for immunization.

Schools have a clear potential for population-based delivery and provide an opportunity to
verify/screen for vaccination status to increase coverage. Moreover, when vaccination
coverage is low, disease outbreaks can cause disruptions to the education system. With
these considerations in mind, vaccination can provide a platform to engage with the
education sector to serve their mutual interest of improving children’s well-being.

However, before implementing school vaccination programmes, countries need to be able

to assess the capacity, strengths, and weaknesses of their school and health systems to
support such programmes. Undertaking a readiness assessment will aid countries in their
decision-making and planning, but can also be used by countries wishing to improve the
performance of their existing school vaccination activities.

The content of this Readiness Assessment Tool is based on a comprehensive review of the
scientific literature related to school vaccination and school health services in developed
and developing countries, global education statistics, and initial experiences with
implementing HPV vaccines. A list of the most pertinent documents is available in the
Bibliography.

Purposes:
The three primary purposes of the School Vaccination Readiness Assessment Tool are:

1. To help Ministries of Health and Education determine, monitor, and improve their
country’s overall readiness to conduct school vaccination activities.

2. To provide a simple-to-use assessment of a country’s overall capacity and specific

strengths and weakness to implement school vaccination activities.

3. To guide a process to improve overall readiness and initiation of a new school vaccination
programme or to improve an existing one.

While this Readiness Assessment Tool is specifically designed to assess country-wide

readiness to implement school vaccination, it might also provide information useful for
assessing and subsequently improving broader school health services. It may be

1
School vaccination in this document refers to any routine vaccination that is administered on school grounds, targets
enrolled students and potentially others, is held before, during, and/or after school hours, and typically involves
collaboration between the health and education sectors. It does not refer to vaccination that occurs at schools as part of
supplemental immunization events such as measles vaccination campaigns or Polio Immunization Days (NIDs).

5
appropriate in many countries to combine school vaccination activities with other school
health services2.

Directions for Use:

There is no single way to implement this School Vaccination Readiness Assessment Tool.
Each country will need to find the approach that best meets its particular needs.

Personnel - It is strongly recommended that a team be appointed to complete the

Readiness Assessment Tool activities. The team should consist of persons from the
Ministries of Health and Education (from the school health, immunization, educational
statistics, and national statistical office/population census programmes), WHO and UNICEF
EPI focal points, and other country-level expertise. While a team of three to five persons is
recommended, smaller and larger teams can work effectively as well. Each team member
should commit to spending at least one full day together, plus additional time for pre-
meeting preparation and post-meeting report writing.

Process - The Readiness Assessment Tool should be distributed to all team members in
advance so that relevant documents and data can be gathered. At a minimum, the
following materials should be available to the team:
-census data/population estimates
-national education statistics, including data by school and school locations
-policies on immunization, school enrollment, and school attendance
-information on groups not receiving schooling
-results of surveys on characteristics of school health programmes and support for school
vaccination
-plans, reports, and evaluations from previous school vaccination activities or other
vaccination programmes

All team members should understand that the quality of the Readiness Assessment Tool
process is dependent on honest exchange of ideas and use of accurate and detailed data
and other types of information. It is important that team members review together the
policies, plans, statistics, and other information addressed in each module. Further, these
materials should be retained as part of the documentation of the Readiness Assessment
Tool process.

The Readiness Assessment Tool consists of three modules:

(1) Overall Readiness;
(2) School Readiness; and
(3) Implementation Readiness.

The team should decide together which of these modules it will use. It is possible to
complete each module separately, do just the first two and save the third on

2
School health services are services from medical, teaching and other professionals applied in or out of school to improve
the health and well-being of children and in some cases, whole families. These services have developed in different ways
around the globe but the fundamentals are constant: the services are to provide early detection, correction, prevention or
amelioration of disease, disability and abuse and include health promotion.
6
Implementation Readiness until the planning process is further along, or do all three at
once.

The Readiness Assessment Tool has been designed to generate quantitative scores that can
be used to identify strengths and weaknesses and lead to the development of a Readiness
Improvement Plan. Assuming that resources (staff, money, and time) are always limited to
at least some extent, the scoring system can be a critical feature for prioritizing actions and
developing a realistic and achievable workplan. Further, if countries repeat the Readiness
Assessment Tool process, the scoring system also provides a built-in monitoring mechanism
that countries can use to assess their progress in improving their readiness to conduct a
school vaccination.

Nonetheless, it is also possible to use the Readiness Assessment Tool in a more qualitative
manner that is less structured and formal and that still yields useful insights about strengths
and weaknesses and helps guide the readiness improvement process. Countries that
choose this approach should still read the Scoring Questions and Descriptions and use them
to guide their discussions about strengths and weaknesses and plans for conducting school
vaccination.

For countries choosing to use the scoring system, begin by completing the Score Card for
each module. It is very important to carefully read the Scoring Questions and Descriptions
for each item in the Score Card before attempting to provide a score. Work as a group to
agree on the most appropriate score. To score as accurately as possible, review data or
documents you already have available or consult with others to best score each item.
Retain the data and documents that are reviewed so they may be included in the Readiness
Assessment and Improvement Plan which will be created after the readiness assessment is
completed. Calculate an overall Module Score (%) after each Score Card is completed
following the directions at the bottom of each Score Card.

All countries should then review the three Planning Questions for each module:
1. What are your country’s strengths and weaknesses?
2. What actions could be taken to improve your country’s readiness to conduct school
vaccination?
3. What are the highest priority actions your country will take to improve its readiness to
conduct school vaccination?

Use the worksheets provided for each module to record the answers to these questions.
Base the selection of priority actions on an assessment of the importance, cost, time,
commitment, and feasibility of each action.

Once the priority actions have been addressed, countries using the quantitative scoring
system should then rescore each module, hopefully obtain a higher overall Module Score
(%), and then set new priorities for further action and improvement. Overtime, strive to
obtain the highest overall Module Score (%) possible to ensure the greatest likelihood of
success and sustainability for your school vaccination activities.

When all the modules are complete, all countries should develop a Readiness Assessment
Improvement Plan based on the outline provided on page 29 and accompanying Workplan
7
provided on page 30. Share this Plan with leadership in the ministries of health and
education and community and school stakeholders.

8
Module 1: Overall Readiness - Score Card

Instructions: As a team, carefully read and discuss the Module 1 Scoring Questions and
Descriptions for each item listed on pages 9-12. Then circle the most appropriate score for
each item on the Score Card below. After all the items have been scored, calculate the
overall Module Score and complete the Module 1 Planning Questions on pages 13-14.

Fully Partially Being Not

Available Available Developed Available
1-1 National policy in support of school vaccination 3 2 1 0

1-2 Formal agreement between Ministries of Health 3 2 1 0

and Education
1-3 National experience providing health services in 3 2 1 0
schools
1-4 National experience conducting school 3 2 1 0
vaccination
1-5 Census data/population estimates by sex and 3 2 1 0
age for all school-aged children
1-6 Information on the distribution of students by 3 2 1 0
grade, age, and sex and proportion of each
cohort enrolled in school
1-7 Information on the official school year calendar 3 2 1 0

1-8 Support from local school officials nationwide 3 2 1 0

1-9 Support from parents nationwide 3 2 1 0

1-10 Information about the type of parental and 3 2 1 0

student approval (consent) required
1-11 Alternative vaccination sites for absent and out- 3 2 1 0
of-school children
Column Totals: For each column, total circled
numbers and enter the sum in this row.
Total Points: Add the 4 sums above and
enter the total to the right.
Module Score: Total Points/33 X 100 __%

9
Module 1: Overall Readiness - Scoring Questions and Descriptions

1-1 National policy in support of school vaccination

Has your country established a national policy approved by the Ministries of Health and
Education in support of school vaccination and has it been distributed to all schools?

3 = Yes.
2 = There is a national policy in support of school vaccination, but it is incomplete or has not
been distributed to all schools.
1 = No, but a national policy in support of school vaccination is being developed.
0 = No and no plans are in place to develop a national policy in support of school
vaccination.

1-2 Formal agreement between Ministries of Health and Education

Have the Ministries of Health and Education established a formal (written) agreement or
memorandum of understanding that provides staff appointed by each ministry with
sufficient authority, decision making power, and regular opportunities for collaboration to
support school vaccination?

3 = Yes.
2 = An agreement is in place, but staff are not appointed or staff are appointed, but no
agreement exists or staff who are appointed lack sufficient authority or regular
opportunities for collaboration to sufficiently support school vaccination.
1 = No, but a written agreement or memorandum of understanding between the ministries
of health and education will be established and staff from both ministries will be appointed
to the school vaccination programme.
0 = No and no plans are in place to establish a formal agreement between the ministries of
health and education or to appoint staff to the school vaccination programme.

1-3 National experience providing health services in schools

Does your country have experience providing health services in schools?

3 = Yes, national-level experience providing health services in schools.

2 = Our country has only regional- or local-level experience providing health services in
schools.
1 = No, but plans are in place to gain experience providing health services in schools.
0 = No and our country does not have any plans to provide health services in schools.

10
1-4 National experience conducting school vaccination

Does your country have experience conducting school vaccination?

3 = Yes, national-level experience conducting school vaccination.

2 = Our country has only regional- or local-level experience conducting school vaccination.
1 = No, but plans are in place to gain experience conducting school vaccination.
0 = No and our country does not have any plans to conduct school vaccination.

1-5 Census data/population estimates by sex and age for all school-aged children

Has your country conducted a census or national survey during the past 5 years that
accurately describes the number of school-aged children (ages 5-18) nationwide by sex and
year of age?

3 = Yes.
2 = Census data/population estimates are available, but they were not collected during the
past 5 years, do not cover the entire country, or do not accurately describe the number of
school-aged children by sex and year of age.
1 = No, but a census or national survey will be undertaken in the next 5 years that will
provide this information.
0 = No and no plans are in place to conduct a census or national survey that would provide
this information.

1-6 Information on the distribution of students by grade, age, and sex and proportion of
each cohort enrolled in school.

Do you have information on the distribution of students by grade, age, and sex and
proportion of each cohort enrolled in school?

3 = Yes.
2 = Information on the distribution of students by grade, age, and sex and proportion of
each cohort enrolled in school is available for some but not all grades.
1 = No, but a plan is in place to collect this information.
0 = No and no plans are in place to collect this information.

1-7 Information on the official school year calendar

Does your Ministry of Health have detailed information on the official school year calendars
(and how they might be affected by seasonal activities and the weather) in public and
private schools including starting and ending dates, school holidays, and exam periods or
other days that would not be appropriate for conducting a school vaccination?

3 = Yes.
2 = Information on the official school year calendar is available for some schools but not all.
1 = No, but information on the official school year calendar will be collected.
0 = No and no plans are in place to collect information on the official school year calendar.
11
1-8 Support from local school officials* nationwide

*Head masters, principals, administrators, etc.

Does your Ministry of Health have support from local school officials nationwide for school
vaccination in general and female-only vaccination specifically?

3 = Yes.
2 = Only local school officials in some regions support school vaccination in general and
female-only vaccination specifically or support from local school officials is limited only to
school vaccination in general, but not necessarily to female-only vaccination.
1 = No, but efforts are underway to build support from local school officials nationwide for
school vaccination in general and female-only vaccination specifically.
0 = No and no plans are in place to build support from local school officials for school
vaccination in general and female-only vaccination specifically.

1-9 Support from parents nationwide

Does your country have support from parents for school vaccination in general and female-
only vaccination specifically?

3 = Yes throughout the country parents support all school vaccination.

2 = Only parents in some regions are in support of school vaccination in general and female-
only vaccination specifically or support from parents is limited only to school vaccination in
general, but not necessarily to female-only vaccination.
1 = No, but efforts are underway to build support from parents nationwide for school
vaccination in general and female-only vaccination specifically.
0 = No and no plans are in place to build support from parents for school vaccination in
general and female-only vaccination specifically.

1-10 Information about the type of parental and student approval (consent) required

Does your Ministry of Health have detailed information about the type of parental and
student approval (consent) required for school vaccination, particularly for vaccines given to
young girls?

3 = Yes.
2 = Information is only available from schools on the type of parental and student approval
(consent) required for school health services in general, but not for school vaccination.
1 = No, but plans are being developed to collect information on the type of parental and
student approval (consent) required for school vaccination.
0 = No and no plans are in place to collection information on the type of parental and
student approval (consent) required for school vaccination.

12
1-11 Alternative vaccination sites for absent and out-of-school children

Has your country identified alternative vaccination sites nationwide for children who are
absent from school or not enrolled in school?

3 = Yes.
2 = Some alternative vaccination sites have been identified, but not enough to provide
nationwide coverage.
1 = No, but plans are underway to identify alternative vaccination sites.
0 = No and no plans are in place to identify alternative vaccination sites.

13
Module 1: Overall Readiness - Planning Questions

Planning Question 1: Look back at the scores you assigned to each question. According to
these scores, identify your country’s strengths and weaknesses. A score of 3 indicates a
strength, a score of 2 may be a strength or weakness, and scores of 1 or 0 indicate
weaknesses. Overall, what capacity does your country already have to initiate a successful
school vaccination programme? What areas need improvement?

Strengths –

Weaknesses -

Planning Question 2: For each of the weaknesses identified above, list several
recommended actions to improve your country’s readiness to conduct vaccination in
schools.

14
Planning Question 3: List each of the actions identified in Planning Question 2 on the table below. Use the 5-point scales defined below to
rank each action on 5 dimensions (importance, cost, time, commitment, and feasibility). Total the number of points for each action. Use the
total points to determine the highest priority actions your country will take to improve its readiness to conduct school vaccination.

Importance How important is the action?

5 = very important 3 = moderately important 1 = not important
Cost How expensive would it be to plan and implement the action?
5 = not expensive 3 = moderately expensive 1 = very expensive
Time How much time and effort would it take to implement the effort?
5 = little or no time and effort 3 = moderate time and effort 1 = very great time and effort
Commitment How enthusiastic are health and education officials about implementing the action?
5 = very enthusiastic 3 = moderately enthusiastic 1 = not enthusiastic
Feasibility How feasible would it be to attain the action?
5 = very feasible 3 = moderately feasible 1 = not feasible

Total Priority
Module 1 Actions Importance Cost Time Commitment Feasibility Points Action

15
Module 2: School Readiness – Score Card
Instructions: As a team, carefully read and discuss the Module 2 Scoring Questions and
Descriptions for each item listed on pages 16-19. Then circle the most appropriate score for
each item on the Score Card below for all schools providing primary (P) and secondary (S)
education. Please consider both public and private or non-public schools including religious
schools and other schools run by non-governmental organizations. After all the items have
been scored, calculate the overall Module Score and complete the Module 2 Planning
Questions on pages 20-21.

Fully Partially Being Not

Available Available Developed Available
P S P S P S P S
2-1 Compulsory education policy for both 3 3 2 2 1 1 0 0
primary and secondary education
2-2 Information on the location of all schools 3 3 2 2 1 1 0 0
2-3 Enrollment data by school for all schools, by 3 3 2 2 1 1 0 0
grade, sex, and age
2-4 Attendance rate data for all schools by sex 3 3 2 2 1 1 0 0
2-5 Name-based enrollment records in all 3 3 2 2 1 1 0 0
schools
2-6 Name-based attendance tracking in all 3 3 2 2 1 1 0 0
schools
2-7 School nurses/health workers/school health 3 3 2 2 1 1 0 0
coordinators in all schools
2-8 School health services in all schools 3 3 2 2 1 1 0 0
2-9 Policy on vaccination requirements for entry 3 3 2 2 1 1 0 0
into all schools
2-10 Student health records in all schools 3 3 2 2 1 1 0 0
2-11 Source of clean water in all schools 3 3 2 2 1 1 0 0
2-12 Appropriate location for immunization in all 3 3 2 2 1 1 0 0
schools
2-13 Experience obtaining parental and student 3 3 2 2 1 1 0 0
approval (consent) for vaccination and other
health services in all schools
2-14 Information on the location of the nearest 3 3 2 2 1 1 0 0
health care facility and its distance from
each school
Column Totals: For each column, total
circled numbers and enter the sum in this
row.
Total Points: Add the 4 sums above for
primary schools and the 4 sums above for
secondary schools and enter the 2 totals to
the right.
Module Score: Total Points/42 X 100 __% __%

16
Module 2: School* Readiness - Scoring Questions and Descriptions

*Includes all public and private or non-public schools including religious schools and other
schools run by non-governmental organizations providing primary and secondary education.

2-1 Compulsory education policy for both primary and secondary education

Has your country established a compulsory education policy for both primary and secondary
education?

3 = Yes.
2 = There is a compulsory education policy, but it only applies to primary education.
1 = No, but a compulsory education policy is being developed.
0 = No and no plans are in place to develop a compulsory education policy.

2-2 Information on the location of all schools

Does your Ministry of Heath have detailed information on the location of all schools?

3 = Yes.
2 = Information is available on the location of some schools but not all.
1 = No, but information on the location of all schools will be collected.
0 = No and no plans are in place to collect information on the location of all schools.

2-3 Enrollment data by school for all schools by grade, sex, and age

Does your Ministry of Heath have detailed data collected during this school year or the last
school year on enrollment by grade, sex, and age for all schools?

3 = Yes.
2 = Enrollment data are available for some schools but not all.
1 = No, but enrollment data will be collected.
0 = No and no plans are in place to collect enrollment data from all schools.

2-4 Attendance rate data* for all schools by sex

*Percentage of students attending school on one or more days.

Does your Ministry of Heath have attendance rate data collected at least once during this
school year or the last school year for most schools nationwide by sex?

3 = Yes.
2 = Attendance rate data are available for only a few schools.
1 = No, but attendance rate data will be collected from most schools.
0 = No and no plans are in place to collect attendance rate data from most schools.

17
2-5 Name-based enrollment records in all schools

Do all schools in your country maintain enrollment records by student name?

3 = Yes.
2 = Only some schools maintain enrollment records by student name.
1 = No, but all schools will be required to maintain enrollment records by student name
starting this school year or the next school year.
0 = No and no plans are in place to require schools to maintain enrollment records by
student name.

2-6 Name-based attendance tracking in all schools

Do all schools in your country track daily attendance by student name?

3 = Yes.
2 = Only a few schools track daily attendance by student name.
1 = No, but all schools will be required to track daily attendance by student name starting
this school year or the next school year.
0 = No and no plans are in place to require schools to track daily attendance by student
name.

2-7 School nurses/health workers/school health coordinators in all schools

Does your country have school nurses/health workers/school health coordinators available
in all schools?

3 = Yes.
2 = School nurses/health workers/school health coordinators are available in only some
schools.
1 = No, but plans are in place to increase the availability of school nurses/health
workers/school health coordinators in schools.
0 = No and no plans are in place to increase the availability of school nurses/health
workers/school health coordinators in schools.

2-8 School health services in all schools

Do all schools in your country provide school health services?

3 = Yes.
2 = Only some schools provide school health services.
1 = No, but plans are in place to increase the number of schools providing school health
services.
0 = No and no plans are in place to increase the number of schools providing school health
services.

18
2-9 Policy on vaccination requirements for entry into all schools

Do all the schools in your country have a policy requiring students to receive specific
vaccinations prior to school entry?

3 = Yes.
2 = Only some schools have a policy requiring students to receive specific vaccinations prior
to school entry.
1 = No, but all schools will be required to require students to receive specific vaccinations
prior to school entry starting this school year or the next school year.
0 = No and no plans are in place to require schools to require students to receive specific
vaccinations prior to school entry.

2-10 Student health records in all schools

Do all the schools in your country maintain student health records (including vaccination
status) for all students?

3 = Yes.
2 = Only some schools maintain student health records (including vaccination status) for all
students or all student health records do not include vaccination status.
1 = No, but all schools will be required to maintain student health records (including
vaccination status) for all students starting this school year or the next school year.
0 = No and no plans are in place to require schools to maintain student health records
(including vaccination status) for all students.

2-11 Source of clean water in all schools

Do all the schools in your country have a source of clean water that can be used during
school vaccination activities?

3 = Yes.
2 = Only some schools have a source of clean water that can be used during school
vaccination activities
1 = No, but plans are in place to help establish a source of clean water for all schools.
0 = No and no plans are in place to help establish a source of clean water for all schools.

19
2-12 Appropriate location* for immunization in all schools

*An appropriate location is clean and safe for all students and staff and big enough to hold
all the vaccination supplies and provides privacy for vaccine administration.

Do all the schools in your country have an appropriate location that can be used to
administer vaccination?

3 = Yes.
2 = Only some schools have an appropriate location in which to administer vaccination.
1 = No, but plans are in place to help establish appropriate locations in all schools.
0 = No and no plans are in place to help establish appropriate locations in all schools.

2-13 Experience obtaining parental and student approval (consent) for vaccination and
other health services in all schools

Do all the schools in your country have experience obtaining parental and student approval
(consent) for school vaccination and other school health services?

3 = Yes.
2 = Only some schools have experience obtaining parental and student approval (consent)
for vaccination or have experience obtaining parental and student approval (consent) only
for other health services.
1 = No, but plans are in place to help schools share their experiences obtaining parental and
student approval (consent) for vaccination and other health services.
0 = No and no plans are in place to help schools learn about the experiences of other
schools who have obtained parental and student approval (consent) for vaccination and
other health services.

2-14 Information on the location of the nearest health care facility and its distance from
each school

Does your country have detailed information for each school on the location of the nearest
health care facility and its distance from the school?

3 = Yes.
2 = Information on the location of the nearest health care facility and its distance from the
school is available for some schools but not all.
1 = No, but information on the location of the nearest health care facility and its distance
from each school will be collected.
0 = No and no plans are in place to collect information on the location of the nearest health
care facility and its distance from each school.

20
Module 2: School Readiness - Planning Questions

Planning Question 1: Look back at the scores you assigned to each question. According to
these scores, identify your country’s strengths and weaknesses. A score of 3 indicates a
strength, a score of 2 may be a strength or weakness, and scores of 1 or 0 indicate
weaknesses. Overall, what capacity does your country already have to initiate a successful
school vaccination programme? What areas need improvement?

Strengths –

Weaknesses -

Planning Question 2: For each of the weaknesses identified above, list several
recommended actions to improve your country’s readiness to conduct a school vaccination
programme.

21
Planning Question 3: List each of the actions identified in Planning Question 2 on the table below. Use the 5-point scales defined below to
rank each action on 5 dimensions (importance, cost, time, commitment, and feasibility). Total the number of points for each action. Use the
total points to determine the highest priority actions your country will take to improve its readiness to conduct school vaccination.

Importance How important is the action?

5 = very important 3 = moderately important 1 = not important
Cost How expensive would it be to plan and implement the action?
5 = not expensive 3 = moderately expensive 1 = very expensive
Time How much time and effort would it take to implement the effort?
5 = little or no time and effort 3 = moderate time and effort 1 = very great time and effort
Commitment How enthusiastic are health and education officials about implementing the action?
5 = very enthusiastic 3 = moderately enthusiastic 1 = not enthusiastic
Feasibility How feasible would it be to attain the action?
5 = very feasible 3 = moderately feasible 1 = not feasible

Total Priority
Module 2 Actions Importance Cost Time Commitment Feasibility Points Action

22
Module 3: Implementation Readiness - Score Card

Instructions: As a team, carefully read and discuss the Module 3 Scoring Questions and
Descriptions for each item listed on pages 23-26. Then circle the most appropriate score for
each item on the Score Card below. After all the items have been scored, calculate the
overall Module Score and complete the Module 3 Planning Questions on pages 27-28.

Fully Partially Being Not

Available Available Developed Available
3-1 Vaccine supply 3 2 1 0

3-2 Related vaccination programme supplies 3 2 1 0

(syringes, tally sheets, etc.) and other resources
3-3 Waste disposal plan for used syringes and 3 2 1 0
needles
3-4 Plan for transportation of the health care 3 2 1 0
facility staff and vaccine supplies to schools,
including maintaining the cold chain
3-5 Plan to address adverse events 3 2 1 0

3-6 Communication and educational materials for 3 2 1 0

schools, communities, and parents
3-7 Plan for roll-out of school vaccination 3 2 1 0
programme

3-8 Training programme for health care facility staff 3 2 1 0

who will administer the school vaccination
3-9 Training programme for local school staff who 3 2 1 0
will support and help with school vaccination
3-10 System for monitoring coverage 3 2 1 0

3-11 Plan for overall evaluation of the school 3 2 1 0

vaccination programme
3-12 Plan for administering vaccinations to absent 3 2 1 0
and out-of-school children
Column Totals: For each column, total circled
numbers and enter the sum in this row.
Total Points: Add the 4 sums above and
enter the total to the right.
Module Score: Total Points/36 X 100 __%

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Module 3: Implementation Readiness - Scoring Questions and Descriptions

3-1 Vaccine supply

Does your country have a sufficient supply of the vaccine available to provide all eligible
students with the proper dose in a timely manner?

3 = Yes.
2 = There is not a sufficient supply of the vaccine available for all students to receive the
proper dose.
1 = No, but a mechanism is in place that will make a sufficient supply of the vaccine available
in the next 12 months.
0 = No and it is unclear how a sufficient supply of the vaccine can be made available.

3-2 Related vaccination programme supplies (syringes, tally sheets, etc.)* and other
resources

*Supplies could include syringes, needles, tally sheets, vaccine carriers, ice packs, safety
boxes, and vaccination cards.

Does your country have a sufficient amount of the supplies available to support nationwide
school vaccination?

3 = Yes.
2 = There is not a sufficient amount of supplies available to support nationwide school
vaccination.
1 = No, but a mechanism is in place that will make a sufficient amount of the supplies
available in the next 12 months.
0 = No and it is unclear how a sufficient amount of the supplies can be made available.

3-3 Waste disposal plan for used syringes and needles

Does your country have a detailed plan for how used syringes and needles will be
handled/disposed and has it been distributed to all schools?

3 = Yes.
2 = There is a plan for how used syringes and needles will be handled/disposed, but it is
incomplete or has not been distributed to all schools.
1 = No, but a plan for how used syringes and needles will be handled/disposed is being
developed.
0 = No and no plans are in place to develop a plan for how used syringes and needles will be
handled/disposed.

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3-4 Plan for transportation of the health care facility staff and vaccine supplies to schools,
including maintaining the cold chain

Does your country have a detailed plan for transportation of the health care facility staff and
vaccine supplies to schools, including maintaining the cold chain, that has been distributed
nationwide?

3 = Yes.
2 = There is a plan for transportation of the health care facility staff and vaccine supplies to
schools, but it is incomplete, does not include maintaining the cold chain, or has not been
distributed nationwide.
1 = No, but a plan for transportation of the health care facility staff and vaccine supplies to
schools is being developed.
0 = No and no plans are in place to develop a plan for transportation of the health care
facility staff and vaccine supplies to schools.

3-5 Plan to address adverse events

Does your country have a detailed plan for how to address adverse events resulting from
school vaccination and has it been distributed to all schools?

3 = Yes.
2 = There is a plan for how to address adverse events resulting from school vaccination, but
it is incomplete or has not been distributed to all schools.
1 = No, but a plan for how to address adverse events resulting from school vaccination is
being developed.
0 = No and no plans are in place to develop a plan for how to address adverse events
resulting from school vaccination.

3-6 Communication and educational materials for schools, communities, and parents

Has your country developed or obtained good communication or educational materials

about school vaccination for schools, communities, and parents and a plan for distributing
those materials nationwide?

3 = Yes.
2 = Our country has some communication and educational materials, but they are
incomplete or there is no plan for distributing the materials nationwide.
1 = No, but a plan is in place to obtain or create communication or educational materials in
the next 12 months.
0 = No and it is unclear how any communication or educational materials will be obtained.

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3-7 Plan for roll-out of school vaccination programme

Does your country have a detailed plan for how to roll-out a school vaccination programme
nationwide and has it been distributed to all schools?

3 = Yes.
2 = There is a plan for how to roll-out a school vaccination programme nationwide, but it is
incomplete or has not been distributed to all schools.
1 = No, but a plan for how to roll-out a school vaccination programme nationwide is being
developed.
0 = No and no plans are in place to develop a plan for how to roll-out a school vaccination
programme nationwide.

3-8 Training programme for health care facility staff who will administer the school
vaccination

Does your country have a good training programme for health care facility staff on how to
administer school vaccination and plans for making the training programme available
nationwide?

3 = Yes.
2 = There is a training programme, but it is incomplete or no plan is in place for making the
programme available nationwide.
1 = No, but a training programme is being developed.
0 = No and no plans are in place to develop a training programme.

3-9 Training programme for local school staff who will support and help with school
vaccination

Does your country have a good training programme for local school staff on how to support
and help with school vaccination and plans for making the training programme available
nationwide?

3 = Yes.
2 = There is a training programme, but it is incomplete or no plan is in place for making the
programme available nationwide.
1 = No, but a training programme is being developed.
0 = No and no plans are in place to develop a training programme.

26
3-10 System for monitoring coverage

Does your country have a nationwide system in place for monitoring vaccine coverage of
school vaccination?

3 = Yes.
2 = There is a vaccine coverage monitoring system, but it is incomplete or not being used
nationwide.
1 = No, but a vaccine coverage monitoring system is being developed.
0 = No and no plans are in place to develop a vaccine coverage monitoring system.

3-11 Plan for overall evaluation of the school vaccination programme

Does your country have a detailed plan for the overall evaluation of the school vaccination
process and its impact?

3 = Yes.
2 = There is an evaluation plan, but it is incomplete or not being used nationwide.
1 = No, but an evaluation plan is being developed.
0 = No and no plans are in place to develop an evaluation plan.

3-12 Plan for administering vaccinations to absent and out-of-school children

Does your country have a detailed plan for administering vaccinations to absent and out-of-
school children?

3 = Yes.
2 = There is a plan for administering vaccinations to absent and out-of-school children, but it
is incomplete.
1 = No, but a plan for administering vaccinations to absent and out-of-school children is
being developed.
0 = No and no plans are in place to develop a plan for administering vaccinations to absent
and out-of-school children.

27
Module 3: Implementation Readiness – Planning Questions

Planning Question 1: Look back at the scores you assigned to each question. According to
these scores, identify your country’s strengths and weaknesses. A score of 3 indicates a
strength, a score of 2 may be a strength or weakness, and scores of 1 or 0 indicate
weaknesses. Overall, what capacity does your country already have to initiate successful
school vaccination? What areas need improvement?

Strengths –

Weaknesses -

Planning Question 2: For each of the weaknesses identified above, list several
recommended actions to improve your country’s readiness to conduct school vaccination.

28
Planning Question 3: List each of the actions identified in Planning Question 2 on the table below. Use the 5-point scales defined below to
rank each action on 5 dimensions (importance, cost, time, commitment, and feasibility). Total the number of points for each action. Use the
total points to determine the highest priority actions your country will take to improve its readiness to conduct school vaccination.

Importance How important is the action?

5 = very important 3 = moderately important 1 = not important
Cost How expensive would it be to plan and implement the action?
5 = not expensive 3 = moderately expensive 1 = very expensive
Time How much time and effort would it take to implement the effort?
5 = little or no time and effort 3 = moderate time and effort 1 = very great time and effort
Commitment How enthusiastic are health and education officials about implementing the action?
5 = very enthusiastic 3 = moderately enthusiastic 1 = not enthusiastic
Feasibility How feasible would it be to attain the action?
5 = very feasible 3 = moderately feasible 1 = not feasible

Total Priority
Module 3 Actions Importance Cost Time Commitment Feasibility Points Action

29
 School Vaccination
Readiness Assessment Improvement Plan

Once the Score Cards are completed, the overall Module Scores are calculated, and the
Discussion Questions are answered, develop a Readiness Assessment and Improvement Plan
to summarize the Readiness Assessment process and the outcomes of the team’s
deliberations. This document will be critical for the leadership in your ministries and for
community and school stakeholders who will be asked to support and help implement your
school vaccination programme.

Background and Rationale: This section should include an overview of the health
problem(s) that will be addressed by your school vaccination programme and a review of
the current status of school vaccination in your country. If available, include specific
information about
- the numbers of school-aged children who could be reached through school
vaccination
- the numbers and locations of all schools providing primary and secondary
education
- enrollment in all schools by grade, age, and sex
- the location of the nearest health care facility and its distance from each school
providing primary and secondary education

Review of Readiness Assessment Process: This section should describe the members of the
team that completed the Readiness Assessment Tool and the process used to complete
each module.

Summary of Strengths and Weaknesses: Drawing from Planning Question 1 in each

module, summarize in this section your country’s
- strengths
- weaknesses
- overall capacity to implement school vaccination

Include the data (e.g., school enrollment data), documents (e.g., national policy in support
of school-located vaccination programmes), and references (e.g., agreement between the
ministries of health and education) you used to score each module item and/or links to
electronic sources of this information.

Summary of Priority Actions: Drawing from Planning Question 3 in each module, this
section should include a summary of the highest priority actions identified in each module.
Make specific recommendations about which actions should be addressed based on the
analysis by importance, cost, time, commitment, and feasibility already completed.

Then for each priority action complete the Readiness Improvement Workplan. The
Workplan should include the priority actions, the steps that need to be taken to implement
each priority action, and the people who will be responsible for each step and when the
work will be completed. The more details provided in the Workplan the better since this
will serve as a guide for whoever is appointed to implement school vaccination.

30
School Vaccination – Readiness Improvement Workplan

Instructions:
1. List, in priority order, the priority actions the team has recommended.
2. List the specific steps that need to be taken to implement each priority action.
3. List the people who will be responsible for each step and when the work will be completed.
Expand this table as needed.

1. Priority Actions 2. Steps 3. By Whom and When

31
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