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Clin Infect Dis. 2014 Aug 1;59(3):325-32. doi: 10.1093/cid/ciu340. Epub 2014 May 14.

School-located influenza vaccination decreases laboratory-confirmed influenza and improves school attendance.

Author information

1
Division of Infectious Diseases, Children's Hospital Los Angeles Department of Pediatrics and Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California.
2
Division of Infectious Diseases, Children's Hospital Los Angeles.
3
Public Health Laboratory.
4
Immunization Program.
5
Acute Communicable Disease Control, Los Angeles County Department of Public Health, California.

Abstract

BACKGROUND:

School-located influenza vaccination (SLV) programs can efficiently immunize large numbers of school-aged children. We evaluated the impact of SLV on laboratory-confirmed influenza and absenteeism.

METHODS:

Active surveillance for influenza-like illness (ILI) was conducted on 4455 children in 4 SLV intervention and 4 control elementary schools (grades K-6) matched for sociodemographic characteristics during the 2010-2011 influenza season in Los Angeles County, California. Combined nose/throat swabs were collected from febrile children with ILI at presentation to the school nurse or during absenteeism.

RESULTS:

In SLV schools, 26.9%-46.6% of enrolled students received at least 1 dose of either inactivated or live attenuated influenza vaccine compared with 0.8%-4.3% in control schools. Polymerase chain reaction for respiratory viruses (PCR) was performed on 1021 specimens obtained from 898 children. Specimens were positive for influenza in 217 (21.3%), including 2009 H1N1 (30.9%), H3 (9.2%), and B (59.9%). Children attending SLV schools, regardless of vaccination status, were 30.8% (95% confidence interval, 10.1%-46.8%) less likely to acquire influenza compared with children at control schools. Unvaccinated children were indirectly protected in the school with nearly 50% vaccination coverage compared with control schools (influenza rate, 27.1 vs 60.0 per 1000 children; P = .023). Unvaccinated children missed more school days than vaccinated children (4.3 vs 2.8 days per 100 school days; P < .001).

CONCLUSIONS:

Vaccination of at least a quarter of the school population resulted in decreased influenza rates and improved school attendance. Herd immunity for unvaccinated children may occur in schools with vaccination coverage approaching 50%.

KEYWORDS:

herd immunity; influenza; influenza vaccine; school-located influenza vaccination

PMID:
24829215
PMCID:
PMC4155443
DOI:
10.1093/cid/ciu340
[Indexed for MEDLINE]
Free PMC Article

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