Background:
Recommending annual flu vaccination to healthy children is a value-based intervention, and school-based interventions are proved to be effective in increasing vaccination uptake.For the 2021-2022 flu season,a nasal spray vaccine was available,making both the acceptance from a parents’ perspective and the administration out of hospital context easier.In this study the results of a school flu vaccination campaign among children in a large urban area of Rome,Italy,are reported.

Methods:
Target population was children aged 2-6 years. Schools were involved through formal communication channels. Two meetings were organized to engage school representatives in the project.Outcomes included meetings attendance,vaccination coverage and the proportion of naive children vaccinated.Secondary endpoint was the number of opportunistic vaccination among school staff, teacher, or parents.

Results:
Twenty-nine schools were involved,for a total of 2.424 children.Meeting attendance rate was 100%.From november 2021 to january 2022,405 (16.7% of the school attendees) children were vaccinated,of which 228 naive (56.3%).While the flu vaccination rate in other age groups decreased compared to the previous year,it increased in the 2-6 year age group. As for the secondary endpoint, 138 doses were administred.

Conclusion:
In order to improve population health and strengthen the partnership between health professionals and community,engaging with schools for public health programs targeting children can play a pivotal role in increasing acceptance and effectiveness.Finally,this study shows how such intervention can greatly increase the vaccination coverage of children,which in Italy was, on average 2.4% considering the period 2010-2021.