Effectiveness of School-Based Influenza Vaccination
James C. King, Jr., M.D., Jeffrey J. Stoddard, M.D., Manjusha J. Gaglani, M.B., B.S., Kristine A. Moore, M.D., M.P.H., Laurence Magder, Ph.D., Elizabeth McClure, M.D., M.P.H., Judith D. Rubin, M.D., M.P.H., Janet A. Englund, M.D., and Kathleen Neuzil, M.D., M.P.H.
Background Vaccination of children in school is one strategyto reduce the spread of influenza in households and communities.
Methods We identified 11 demographically similar clusters ofelementary schools in four states, consisting of one schoolwe assigned to participate in a vaccination program (interventionschool) and one or two schools that did not participate (controlschools). During a predicted week of peak influenza activityin each state, all households with children in interventionand control schools were surveyed regarding demographic characteristics,influenza vaccination, and outcomes of influenza-like illnessduring the previous 7 days.
Results In all, 47% of students in intervention schools receivedlive attenuated influenza vaccine. As compared with control-schoolhouseholds, intervention-school households had significantlyfewer influenza-like symptoms and outcomes during the recallweek. Paradoxically, intervention-school households (both childrenand adults) had higher rates of hospitalization per 100 personsthan did control-school households. However, there was no differencein the overall hospitalization rates for children or adultsin households with vaccinated children, as compared with thosewith unvaccinated children, regardless of study-group assignment.Rates of school absenteeism for any cause (based on school records)were not significantly different between intervention and controlschools.
Conclusions Most outcomes related to influenza-like illnesswere significantly lower in intervention-school households thanin control-school households. (ClinicalTrials.gov number, NCT00192218
[ClinicalTrials.gov]
.)
Source Information
From the University of Maryland, Baltimore (J.C.K., L.M., J.D.R.); MedImmune, Gaithersburg, MD (J.J.S.); Scott and White Clinic, Texas A&M University, Temple (M.J.G.); University of Minnesota, Minneapolis (K.A.M., E.M.); and University of Washington, Seattle (J.A.E., K.N.).
Address reprint requests to Dr. King at the Department of Pediatrics, University of Maryland School of Medicine, 737 W. Lombard St., Baltimore, MD 21201, or at jking{at}peds.umaryland.edu.
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