Vaccines for School Attendance: How to Effectively Communicate with Parents and Caregivers

Childhood vaccination rates for illnesses such as measles have recently declined. The spread of vaccine-preventable diseases can lead to outbreaks in schools and communities, putting children, staff, and families at risk for developing serious illness. 

Parents and caregivers are at the center of decision-making for their children’s well-being. In fall 2024, Healthier Generation conducted a survey of parents and caregivers of school-age children to learn more about their communication preferences. Participants shared feedback on vaccine requirements and trusted sources of health information, and responded to sample communications from a principal, school nurse, and parent-teacher association (PTA) president. The results highlight the important role that schools and school nurses play in encouraging vaccine uptake.

Leah Ferguson, DrPH., director of evaluation, and Dr. Jessica Reggi, national advisor for Whole Child Health at Healthier Generation, sat down to share key takeaways and strategies to effectively communicate about required vaccines. 

Q: What was the goal of this research?

Dr. Reggi: In our previous research, we learned that parents’ concerns about vaccines primarily fell into two main categories: vaccine safety and the childhood vaccine schedule. We believe schools can serve as accessible hubs for sharing information to promote health literacy and vaccine confidence. 

With that in mind, we set out to learn, specifically within the school setting, who parents trust to receive this kind of information from and how they prefer to learn it.

Q: Parents and caregivers were asked to choose a favorite from three sample messages: a Q&A from a school nurse, a reminder of school vaccine requirements from a principal, and an appeal from a PTA president that emphasized the community benefits of vaccination. Which of these resonated most?

Dr. Ferguson: The message from the school nurse was selected most often; the school nurse was the health professional they trusted most to communicate health information. 

Dr. Reggi: Parents valued medical expertise, a proactive approach, a respectful tone, and concise information.

Q: What do these results say about the role of school nurses in encouraging vaccine uptake?

Dr. Reggi: The role of the school nurse and entire school health services team is crucial to vaccine confidence and uptake. As highlighted in the National Association of School Nurse’s (NASN) School Nursing Practice Framework ™, school nurses are the public health experts within their school or district. 

"Our research affirms that when school nurses have something to say, caregivers are listening. They trust school nurses’ medical expertise and appreciate it when they anticipate potentially sensitive questions that parents may not feel comfortable bringing up."

This trusting relationship can be built over time through communication about various health-related topics, such as the need for a signed consent form for a student to have a dental exam, or the need for a student’s asthma inhaler to be kept at school. Once rapport has been established, conversations about vaccines can be approached.

Q: By a margin of 7 to 1, parents and caregivers agreed that some vaccines should be required for school attendance. What does this say about vaccine confidence?

Dr. Ferguson: Overall, parents believe that vaccines are safe and necessary for preventing disease. However, the spread of misinformation and disinformation have given many parents the impression that some vaccines are more dangerous than the diseases they are meant to prevent. For example, due to declining rates of the MMR (measles, mumps and rubella) vaccination nationally, we are only at 93% coverage. To prevent outbreaks, we need to reach 95% coverage.

Q: More than 80% of parents and caregivers in this survey listed family doctors and pediatricians as a trusted source of information about medical decisions like vaccination. What is the role of clinicians in encouraging vaccine uptake, and how can this complement the efforts of schools and school nurses?

Dr. Reggi: Pediatricians and other clinicians can ensure families understand the need for routine well-child checks because vaccines are often part of these check-ups. During a well-child visit, healthcare providers can make the direct connection between up-to-date vaccination, school-required vaccine compliance, and the well-being of the entire school community. 

Vaccines protect children from viral illnesses that would otherwise keep them home sick from school, which impacts learning time, social-emotional development, and childcare arrangements. Healthcare providers can help parents and caregivers make the connection from vaccines to school attendance.

Q: What role do other school staff play in supporting on-time vaccination?

Dr. Ferguson: My main takeaway is that school leaders’ messages should be consistent. If parents and caregivers hear the same message from many different sources, it highlights the importance and accuracy of the information. Parents want to be partners in healthcare decisions.

Dr. Reggi: To effectively reach the greatest number of families, we recommend that schools share communications related to vaccines from multiple messengers. A helpful resource for educators is Healthier Generation’s 10-minute interactive microlearning, “Engage Families to Address Student Health,” which is available in English and Spanish. 

Q: What other resources can help schools communicate with parents around vaccines?

Dr. Reggi: For schools, Healthier Generation maintains a virtual hub of culturally responsive, up-to-date, evidence-based resources that schools can use to support vaccine confidence and uptake. For parents and caregivers, we have an Ask a Doctor blog series, which answers common questions around vaccines and other health topics based on recommendations from trusted sources like the CDC and American Academy of Pediatrics.

This research was supported by Merck. Learn more about routine vaccinations by exploring our Checklist for Caregivers in English and Spanish.