Sanford’s school superintendent says three students received flu vaccines without parental consent because of several factors, including the process of distributing the permission forms, confusion over the forms themselves and a lack of sufficient checks by school and clinic staff.

Superintendent Matt Nelson said Wednesday that an ongoing district investigation has found that two students were vaccinated in the recent clinics after their parents either did not sign the permission form or only partially filled it out. In a third case, a parent filled out the form, signed it but drew a line through the signature with the letters “NA,” which Nelson said he took to mean “not applicable.”

The district also has reviewed a fourth complaint from a parent who said they did not want their child vaccinated, but who had returned signed paperwork giving permission for the vaccines.

Confusion over the vaccines is something the district hasn’t encountered before, and Nelson said there were a few factors, including inclusion of the permission form for the shots in a packet of back-to-school paperwork this year, that may be to blame. He would not say whether the problems were isolated to one school or which schools the problems occurred at. “I don’t want to violate anybody’s confidentiality,” Nelson said. “I’m trying to protect that.”

Sanford schools have been holding flu vaccine clinics annually for the past several years. Northern Light Home Care and Hospice partners with the district to provide the clinics, which this year have been provided over two weeks at different schools.

Parental consent is required for a vaccine to be administered, but parents do not need to fill out the permission form if they do not want a vaccine. If a student does not return the form, Nelson said the district assumes they do not want the vaccine. He said he did not have a tally Wednesday on how many parents submitted the form even though they did not want their children vaccinated.

Nelson said the district is reviewing protocols and procedures, which may lead to some changes. One thing the district will be looking at is how the forms are collected and who checks them before shots are administered. There is no deadline to hand in the forms, and Nelson said in some cases students may have brought them to school the day of the clinics, resulting in a lack of proper verification.

He said the district would ideally have more than one person verify the information on the form to make sure it is complete and signed. “I don’t want to say it doesn’t happen, but it’s safe to say it may not be happening consistently,” he said.

He also said he is concerned that families may find the form, which is provided by Northern Light, to be confusing. “If you had talked to me probably last week at this time, based on the information we had, I would probably have said, ‘No I don’t think (the forms are confusing),’ but based on what has transpired … you have to sit back and connect the dots and say, ‘This could be confusing,'” he said.

Northern Light issued a statement Tuesday saying three children in Sanford were vaccinated “without fully executed or completely documented consent.” Jacqueline Welsh, director of philanthropy and community relations for Northern Light, said the group would not be answering any questions about how the students received flu shots without parental consent.

She said the group is one of the largest providers of School Located Vaccine Clinics and has contracted with close to 20 school districts and 11 independent schools this year. No other problems have been reported in schools outside of Sanford, Welsh said.

She said Northern Light has averaged about 4,000 student immunizations every year since they began the school program in 2009 and is expecting to exceed that in 2020. As of Wednesday 3,731 students have been immunized through the program with four school districts still remaining.

George Kimball of Springvale, who has two children at Sanford Middle School, said his seventh-grade daughter, Aubrey Kimball, was one of the students in Sanford who received a vaccine without his consent. Kimball, 43, said Aubrey had a bad reaction to an influenza vaccine as a toddler, so he did not want her to get the shot this year.

Kimball said he filled out the influenza shot permission form because it was sent home with other school paperwork, but he purposely did not sign it. Where the form asked what kind of vaccine was preferred, Kimball crossed out both options and wrote “None.”

He filled out the form in the same way for his fifth-grade son, and the school called him to double check on whether he wanted a vaccine. With Aubrey, however, Kimball said the school went ahead with the vaccination.

Part of the form says if you answer “yes” to any of the questions, you should see your healthcare provider. In that section, Kimball answered “yes” to a question about whether his daughter has had a severe reaction to an influenza vaccine in the past, thinking it would imply that she should not get a school vaccine.

“If you’re asked for permission and you say ‘no vaccine’ and you do not sign it … it’s pretty much self-explanatory, I think,” Kimball said.

He said he has received an apology from the school nurse and luckily his daughter has not had a negative reaction to the vaccine. “I don’t know what there is to do,” Kimball said. “I kind of feel helpless. I feel like there’s been a break of trust between some parents and the school.”

Nelson said the district will be reviewing its procedures before the final clinic, which is scheduled for Nov. 4 for remote learners, and will be considering whether to ask for parental permission that day rather than rely on the forms sent home at the start of the year.

“At the end of the day student safety is first and foremost,” he said. “This is something we’re doing that we’ve done for many years with no problems we’re aware of. Where we do contract with an outside agency we have protocols in place where they do require a signed permission form. It’s a situation where there was a failure to notice the permission slip wasn’t signed.

“Obviously we wish that didn’t happen but we are using the opportunity to review our protocols and make any changes and adjustments to ensure it doesn’t happen again.”

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