Model Programs for
Hepatitis A, B, and C Prevention


 School-based programs for adolescents 


Take 3 Hep B

Program name: Take 3 Hep B
Population served: Adolescents
Eligibility: 4th and 5th grade students in Hawaii
Region served: Hawaii statewide
Funding: CDC, Hawaii Department of Health
When did program begin?: First initiative in the 1996-97 school year
Number of clients: 10,000-15,000/year
Contact: Kathleen Newkirk, RN
Executive Director
Kahu Malama Nurses, Inc.
1357 Kapiolani Blvd. #850
Honolulu, HI 96814
Phone: (808) 951-0111
Fax: (808) 949-3834
Website: None


Kahu Malama Nurses, Inc. responded to a call from the Hawaii Department of Health to go into schools and provide education about, and immunizations for, hepatitis B. The target population was 4th and 5th grade students in over 180 schools, with a total target population of approximately 22,000 students per year. These children were born prior to the implementation of the Infant Vaccination Program implemented in Hawaii in 1992, and it was assumed that this cohort included a significant number of unvaccinated students.

The Take 3 Hep B program was launched in September 1996. We established "teams" of licensed nurses who were assigned to geographical areas delineated along school district lines. After a letter of introduction from the school superintendent we contacted individual schools and collected demographic statistics, such as number of classrooms of grades 4 & 5, number of students, and information about the school such as location of an appropriate "clinic" set up, contact name, dates of holidays, teacher educations days, etc. The district teams then began a mass distribution of information in packets sent home with students to their parents (confidentiality restricted access to mailing addresses). The packets were carefully designed to draw maximum attention, provide important information about the disease and prevention, and elicit optimum response. The information was made available in eight languages. Parents were asked to respond to whether or not they wanted their child to receive free hepatitis B immunizations in school based clinics. At the same time, a media campaign was conducted consisting of television, radio, and print ads, many sponsored by contributions from private business.

Once the demographics and participating population were identified (which was an immense ongoing effort requiring telephone follow-up, school memos, attendance at parent/teacher meetings, and more) we scheduled the actual clinics.

The clinics were to last two hours. Adequate staff was assigned to provide one registered nurse to administer vaccine to approximately 25 students per hour. Volunteer staff assisted with check-in and "crowd control." Three areas were delineated in the clinic area, one for checking in the students, a vaccination area which provided some privacy, and a post-vaccination area where the children were asked to remain 15 minutes for observation. This area created the perfect opportunity for providing disease prevention education and good health information.

Children were escorted to the clinic room by their teachers in pre-scheduled increments at least 15-25 minutes apart. The district team personnel arrived a half hour early to set up, then conducted the immunization clinic, completed the paperwork, packed up supplies, cleaned the area, and moved to another school. Some days as many as four clinics were conducted by each team.

The result was that in that first school year over 12,000 children received all three hepatitis B shots, and over 42,000 shots were administered. All those vaccinated were cleared through parental consent obtained in advance. Each child participated in fun educational activities and was rewarded with prizes and incentives donated by local businesses.

The Take 3 Hep B Project was repeated during the next two school years.

Immunization Action Coalition

Hepatitis Prevention Programs

1573 Selby Avenue, Ste. 234
St. Paul, MN 55104
Tel: (651) 647-9009   Fax: (651) 647-9131