A School-Based Vaccination Campaign with Trivalent Live Attenuated Intranasal Vaccine (tLAIV) During the 2024–2025 Influenza Season in Two Schools of Palermo, Italy

Why It Matters

The results show that delivering flu shots directly in schools can dramatically improve pediatric vaccination rates, especially among vulnerable populations, thereby strengthening community immunity and reducing seasonal influenza impact.

Key Takeaways

• 2,140 children offered tLAIV; 415 received vaccine (19.4% adherence).
• Adherence exceeded Palermo LHA coverage and 2022‑23 pediatrician pilot (p<0.001).
• Highest participation observed in disadvantaged, multi‑ethnic school zones.
• No safety incidents reported during on‑site intranasal vaccination.
• Integrating school, pediatrician, and LHA services could raise overall coverage.

Pulse Analysis

Influenza remains a leading cause of pediatric illness and a driver of community transmission, yet Italy’s child vaccination rates lag behind EU targets. Barriers such as limited clinic hours, parental misconceptions, and logistical hurdles often keep families from accessing the intranasal live attenuated influenza vaccine (tLAIV). By moving vaccination to the school environment, health authorities can bypass these obstacles, offering a convenient, needle‑free option that aligns with parents’ daily routines and reduces the need for separate medical appointments.

The Palermo pilot enrolled 2,140 students across two schools with contrasting socioeconomic profiles and achieved a 19.4 % adherence rate—significantly higher than the regional health authority’s overall coverage and a prior pediatrician‑led effort. Notably, the most pronounced uptake occurred in the disadvantaged, multi‑ethnic catchment, suggesting that school‑based delivery can reach populations traditionally underserved by clinic‑based programs. Safety data were clean, with no adverse events reported, reinforcing the suitability of intranasal administration for large‑scale school settings.

These findings have clear policy implications. Integrating school‑based tLAIV campaigns with existing pediatrician networks and Local Health Authority logistics could create a hybrid model that maximizes reach while preserving continuity of care. Such an approach would likely boost herd immunity, lower seasonal flu incidence, and reduce healthcare costs associated with pediatric hospitalizations. As European nations grapple with vaccine hesitancy and resource constraints, Palermo’s experience offers a replicable blueprint for improving childhood influenza coverage in vulnerable communities.