School-based educational and on-site vaccination among adolescents living in rural areas

INTERVENTION: Schools are randomly allocated to one of two groups (high‐intensity and low‐intensity involvement group). Parents are informed in advance and consent is obtained. Both groups receive basic information about the project and the bus, one week before the bus will be at their school. In both conditions, the Prevention Bus is delivering vaccine for MMR, diphtheria, tetanus, pertussis, and polio after education is delivered by medical staff. The Prevention Bus will be at each school for approximately one school week to give all students the possibility to get information and vaccination if needed. Moreover, there will be an intervention at the classes from 9th to 11th grade (15 years onwards) in high schools and for all apprentices in their teaching facilities. More specifically, the intervention will be a 30‐minute educational class, held by doctors for both the high‐intensity involvement condition and the low‐intensity involvement condition on knowledge, risk communication and enhancing self‐efficacy regarding vaccination. Both conditions also include an anonymous questionnaire on sociodemographic background and knowledge regarding vaccination. The check of the vaccination card and a guided tour through the Prevention Bus is part of the intervention for both groups. The low‐intensity involvement condition will receive the above‐described intervention. In addition, in the high‐intensity involvement condition parents of students participating will receive one week before the bus will be at their school detailed information material on infectious diseases and vaccination (flyer) using risk communication methods. Also teachers of the school classes included will receive this material one week in advance. Furthermore, an additional reminder system will serve as cue to action for teachers to remind students more often, and short and long‐term. Parents, teachers and students will further have the possibility to reach the medical and psychological team through interactive CONDITION: MMR vaccine (Measles, Mumps, Rubella), Tdap‐IPV vaccine (Tetanus, Diphteria, Pertussis, Polio) ; Infections and Infestations PRIMARY OUTCOME: Preparedness: The availability of students for a possible vaccination is objectively measured through the number of pupils who bring their vaccination card to school and can get vaccinated if necessary, directly after the educational intervention (high‐intensity involvement condition, low‐intensity involvement condition) when pupils visit the Prevention Bus. The primary outcome will be weighted by the number of pupils who are eligible to take part in the study INCLUSION CRITERIA: School level: 1. Municipalities in the federal state of Brandenburg with less than 200 inhabitants/km² 2. Summed minimum number of pupils in potential School classes per school: 200 Participant level: 1. Age (>15 years) 2. Signed informed consent by the parents SECONDARY OUTCOME: 1. The number of pupils, that get vaccinated directly after the educational intervention (high‐intensity involvement condition, low‐intensity involvement condition) when pupils visit the Prevention Bus. The secondary outcome will be weighted by the number of pupils who are eligible to take part in the study; 2. Health literacy is measured using five items of the HLS‐EU Q47 questionnaire addressing prevention and immunization treatment (educational class condition, low intensity information condition) before students visit the bus while they are still in their classroom; 3. Health knowledge is measured with six previously developed immunization knowledge items, which psychometric properties were tested in the pilot study after treatment (educational class condition, low intensity information condition) but before students visit the bus while they are still in their classroom; 4. Perception of susceptibility to infectious diseases, measured using a risk scale after the educational unit, when students are still in their classroom, but before they enter the bus