Hamilton County Department of Education

Volunteer Army Ammunition Plant, 3074 Hickory Valley Rd, Chattanooga,

TN 37421

Date: April 10, 2017

To: Dr. Steve Highlander
Hamilton County Department of Education
From: Melissa Martin, Student at The University of Tennessee at Chattanooga
Subject: The Administration of Flu Vaccinations in Hamilton County Schools: A
Recommendation Report

Attached is the report for our study, The Administration of Flu Vaccinations in Hamilton County
Schools: A Recommendation Report. We completed the tasks outlined in the Proposal that was
completed, March 6, 2017. We finished research on the following tasks: Determining the costs
associated with administering flu shots, and preparing a budget for the Department of Education
with this information, researching ways to eliminate costs of flu shots to schools, gathering
research statistics about the benefits of flu shots from doctors and physicians, and making a list
of the states where schools are giving flu shots to students and teachers.

To carry out these tasks, we performed primary and secondary research. Our main conclusion
was that it would cost $1,920,000 for the Department of Education to provide flu shots to
students and teachers. While this seems like a large number, my team found programs for the
school board to partner with that would eliminate costs completely. Also given the examples of
states where schools administer flu shots, the proposal is completely feasible. Students
education and teachers careers should not be compromised due to the flu. My team and I hope
that you find the lack of flu shots in schools as severe as a problem as we do.

I appreciate the trust you have shown to myself and my team throughout this project. If you have
any questions or concerns, please contact me on my cell phone at 901-567-8965, or email me at
melissamartin@gmail.com.
 The Administration of Flu Vaccinations in Hamilton County
Schools: A Recommendation Report

Prepared for: Dr. Steve Highlander

School Board District 9, Board Chairman
Hamilton County Department of Education
Prepared by: Melissa Martin, Student at The University of
Tennessee at Chattanooga

April 10, 2017

 Purpose
The purpose of this report is to convey to Dr. Steve Highlander, Board Chairman of Hamilton
County Schools, on the end findings of the research conducted for the case.

Summary
The goal of the research for this proposal to the Hamilton County School Department of
Education was to have flu vaccinations provided to students and teachers in schools. Through
months of research my team has strived to find cost friendly ways to have this plan take effect.
We have stuck carefully to the tasks outlined in our work schedule. We successfully gathered
information about pricing of flu shots by visiting doctors offices. We concluded that flu shots are
roughly around $40 without coupons or insurance deducted. In addition, my team has researched
schools around the United States that budget properly to provide flu shots to their students and
teachers. We created a master list of schools that do this. Lastly, we conducted interviews with
doctors on the benefits of receiving a flu shot to provide primary source information. My team
also visited the websites of many health departments and federal government health sites to
provide statistics on the matter. All of these steps aid in making a compelling case to provide to
the Department of Education.

Our main conclusion was that it would cost $1,920,000 for the Department of Education to
provide flu shots to students and teachers. While this seems like a large number, my team found
programs for the school board to partner with that would eliminate costs completely. Also given
the examples of states where schools administer flu shots, the proposal is completely feasible.
After extensive research, our studies found that 38 million school days are lost each year due to
the flu. Therefore, students education and teachers careers should not be compromised due to
the flu.

My team recommends that the Hamilton County Department of Education allocate 5% of its
budget to giving out flu shots to its students and teachers. We are also requesting that this item on
the budget not be listed under discretionary elements, but treated as a matter of health of safety.
We believe that providing this vaccination will ultimately improve education, and make for a
better school environment overall.

Introduction
To determine the effect of administering flu shots to students and teachers, Dr. Steve Highlander,
requested my team conduct research on the benefits of this course of action. Through interviews
with doctors and physicians we were able to gather facts and statistics on the flu vaccine. We also
conducted interviews with teachers in the school system on their thoughts on the matter. After
doing these things were able to put together a recommendation memo following our proposal.

Currently, the Hamilton County Department of Education does not give flu shots to students and
teachers. As a result, this has already caused one school to shut down due to an endemic
occurring. This situation is not ideal because it hinders the education of students. Ironically, the
Department of Educations slogan is, Providing a World Class Education. Is this actually the
case if schools are shutting down due to an outbreak of the flu? Brown Academy was the first
school, but it will surely not be the last.
Therefore, after the Hamilton County Department of Education read my teams proposal they
realized just how dire the need was for this plan to be implemented. Dr. Steve Highlander asked
us to perform four tasks:
Determine the costs associated with administering flu shots, and prepare a budget for the
Department of Education with this information.
Research ways to eliminate costs of flu shots to schools.
Gather research statistics about the benefits of flu shots from doctors and physicians.
Make a list of the states where schools are giving flu shots to students and teachers.

Research Methods
Dr. Steve Highlander emphasized keeping the Department of Educations slogan in mind, which
is Providing a World Class Education. Therefore, we began our research by sticking to the idea
that the effect of administering flu shots is to better the education of students. We then stuck to
our four main tasks outlined in our proposal:
Determine the costs associated with administering flu shots, and prepare a budget for the
Department of Education with this information.
Research ways to eliminate costs of flu shots to schools.
Gather research statistics about the benefits of flu shots from doctors and physicians.
Make a list of the states where schools are giving flu shots to students and teachers.

Task 1. Determine the costs associated with administering flu shots, and prepare a budget
for the Department of Education with this information.

In order to achieve this step my team and I began by visiting websites of different pharmacies,
clinics, and doctors offices to determine the average cost of a flu shot to be around $40. This
cost enabled us to be able to form a budget for the Department of Education. We also found that
if the Department will agree to allocate 5% of its annual budget to flu shots, then schools will
have the means necessary to give out flu shots to students and teachers.

Task 2. Research ways to eliminate costs of flu shots to schools.

In order to do this step, extensive research was conducted. The first piece of research we found
was an article of a school that is successfully providing flu shots to students and teachers. The
article outlined ways and means by which the school is able to provide flu shots in large
quantities for a lower cost. This data helps our team propose to the same methods to the
Department of Education.

Task 3. Gather research statistics about the benefits of flu shots from doctors and
physicians.

On March 23, 2017, my team gathered a list of the concrete benefits of receiving a flu
vaccination. In order to gather this information, we visited the Tennessee Health Departments
website, and the CDCs website. The website that provided us with cost efficient ways to
administer flu shots in large quantities also contained vital information on how to flu shots
contribute to less absences in schools. We believe that these arguments provide enough logos for
the Department of Education to consider our proposal. Lastly, we contacted doctors in the
Chattanooga area and received feedback from them on the benefits of a flu shot.

Task 4. Make a list of the states where schools are giving flu shots to students and teachers.

For this last task, my team visited websites that provided the states where schools around the
United States are successfully administering flu shots to students and teachers. We found seven
states that are currently bringing our proposal to life. In addition, I conducted an interview with
my mother who works at a private school in Tennessee where they administer flu shots to their
students and faculty. I recorded her feedback on this initiative for the purpose of collecting
primary source data.

Results
In this section, we present the results of our research. Each task presents the most important data
that we collected.

Task 1. Determine the costs associated with administering flu shots, and prepare a budget
for the Department of Education with this information.

After visiting many websites, our team concluded that flu shots cost an average of $40. Given
that schools contain anywhere from 500-1000 students; this means that it would cost anywhere
from $20,000 to $40,000 to vaccinate these students. In addition, schools contain anywhere from
150-200 teachers on average. This means that it would cost $6,000-$8,000 to vaccinate teachers.
Therefore, the maximum total dollars that the Department of Education would spend on flu
vaccinations annually per school is $48,000. There are 80 schools within Hamilton County. This
means that the total amount spent for the county as a whole would be $3,840,000. My team
proposes that the department allocate 10% of its budget to flu vaccinations for students and
teachers. This figure and percentage does not include discounts and insurance.

Task 2. Research ways to eliminate costs of flu shots to schools.

As stated above, our team found an article on how schools have successfully administered flu
shots to students and teachers. The article provides a statement from Mayo Clinic concluding that
it costs less money per dose to administer flu vaccines in a school setting than at a hospital or
clinic. This means that schools are receiving a discount by giving these shots out in large
quantities. This factor changes the numbers in the proposed budget, and cuts the numbers in half.
This means that it costs an average of $1,920,000 a year to vaccinate students and teachers of
every school in Hamilton County. Therefore, my teams final proposal for the Hamilton County
Department of Educations budget is to allocate 5% of funds to flu vaccinations. In addition, my
team found that most insurances cover nearly the whole cost of a flu vaccine. Therefore, teachers
should be covered under their insurance provided by the school. This means that schools could
recruit a team of nurses to vaccinate teachers through their insurance with little to no charge. The
effect of this scenario would be that the department may not even need to budget for teachers at
all. Students as a whole on the other hand do not have health insurance. This means that this
proposal is vital for their health, and the schools health. Lastly, a program that helps offer flu
shots that the department could utilize is the CDC's Vaccines for Children (VFC) program. The
numbers may change a bit when the plan is finalized because each school contains different
needs.

Task 3. Gather research statistics about the benefits of flu shots from doctors and
physicians.

The next task my team and I covered was to find statistics that benefit my proposal to vaccinate
students and teachers. After extensive research, our studies found the following shocking
statistics:
38 million school days are lost each year due to the flu.

In the United States, about 200,000 people are hospitalized and about 36,000 people
die each year because of the flu.

Influenza is easily spread to other students, teachers, family members, and the
community.

A flu shot protects against 3 to 4 strains of the flu virus, which is something that other
vaccines are incapable of.
Because the virus takes at least a week to incubate and fully manifest any symptoms, an
infected patient could be out and about spreading infections. Therefore, receiving a flu
shot lowers the risk of creating an endemic.
People who receive the flu shot every season is 70% less likely to have influenza or
develop symptoms that are often annoying than painful, such as congestion, cough, fever
and body aches.

In addition to secondary source statistics, we interviewed, John Lott, director of nursing at the
Knox County Department of Health. After providing flu vaccines in Knox County, he concludes,
Over the past 4 years, Knox County hasn't had to close any of its schools, even though
surrounding areas have.

Task 4. Make a list of the states where schools are giving flu shots to students and teachers.

The list of states where schools are administering flu shots to students and teachers:
California
Colorado
Hawaii
Louisiana
Maryland
Minnesota
Tennessee
 In addition, I conducted an interview with my mother who is a teacher at a private school in
Memphis, Tennessee. She says, My school has nurses from a local Memphis business come
to our school during the month of November to give flu shots to all staff and faculty. The
money for this comes from our health insurance. It is so vital as a teacher to receive a flu shot
because I am constantly around children who come to school sick. We as teachers have to
take preventative measures to protect ourselves.

After conducting this interview, my team and I learned that even private schools have
initiatives in place to protect their faculty. It is our hope that the Hamilton County
Department of Education will follow in the footsteps of these states and private schools that
have already implemented flu vaccinations.

Conclusions
In this section, my team presents our conclusions based on the research conducted for the four
tasks.

Determine the costs associated with administering flu shots, and prepare a budget for the
Department of Education with this information.
We determined the costs to vaccinate students and teachers to be roughly $24,000 per school.
This means that with insurances and discounts it would cost $1,920,000 a year to vaccinate all
schools in Hamilton County. This would mean that the Hamilton County Department of
Education would allocate 5% of its funds to our cause. An anomaly does not exist here because
my team fully expected large numbers to arise once we calculated our results. There dont appear
to be trends with these numbers because each school is different.

Research ways to eliminate costs of flu shots to schools.

For this task we have concluded that the best thing way to help eliminate costs would be for the
school to use the teachers insurance to cover their flu shots. This would mean that the rest of the
budget would go towards the students being vaccinated. This works better because there are
more students than teachers. An alternative to this solution would be for the schools in Hamilton
County to partner with CDC's Vaccines for Children (VFC) program for lower costs of flu
vaccines. There doesnt appear to be an anomaly or trend here because everything appears
normal. My team researched this issue by visiting government websites.

Gather research statistics about the benefits of flu shots from doctors and physicians.

We conclude that the most compelling statistic for the Hamilton County Department of
Education to use to compel parents to allow their children to be immunized through the school is:
38 million school days are lost each year due to the flu. My team and I believe that this statistic
speaks volumes to the impact that illness has on education. There doesnt appear to be an
anomaly or any trends here. My team simply looked up statistics.

Make a list of the states where schools are giving flu shots to students and teachers.
This is the list that my team and I compiled of the schools who have implemented our initiative:
California
 Colorado
Hawaii
Louisiana
Maryland
Minnesota
Tennessee
These results seem normal and there doesnt appear to be any trends here. There is a significant
range in characteristics between these states as each state is located in a different region of the
U.S. My team did expect to find a larger number of states administering flu shots than these,
however. However, there are multiple schools within these states that have already implemented
our initiative. This means that there are more schools than it seems.

Recommendations
My team and I recommend that the Hamilton County Department of Education pick one of two
options:

Option 1: My team recommends that the Hamilton County Department of Education

allocate 5% of its budget to giving out flu shots to its students and teachers. We are also
requesting that this item on the budget not be listed under discretionary elements, but treated as a
matter of health of safety. We believe that providing this vaccination will ultimately improve
education, and make for a better school environment overall.

Option 2: My team recommends that the Hamilton County Department of Education

partner with CDC's Vaccines for Children (VFC) program to help eliminate costs of
associated with flu shots altogether. The Department should either do this or partner with a
local clinic in the Chattanooga area to eliminate costs. Either way, this option would be more
difficult to achieve because it involves more work.
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