Bridging Vaccine Access and Attitudes: An Integrative Review of U.S. School-Based Vaccination Programs

School-based vaccination programs in the United States are a vital component of public health strategy, offering a practical and equitable means of reaching diverse child and adolescent populations. As key sites for immunization delivery, schools have historically contributed to the success of vaccine initiatives while also reflecting the social, cultural, and logistical complexities that shape public health outcomes. This literature review synthesizes research on vaccination programs implemented in the K-12 educational system, with a focus on ethical considerations, cost-efficiency, community engagement, and operational challenges. Grounded in the Health Belief Model, this integrative review explores how risk perceptions, communication strategies, and healthcare provider capacity influence vaccine acceptance and uptake. It further examines how individual decision-making and structural barriers-such as regional policy variation, consent procedures, and school nurse availability-affect program success.