PLoS ONE (Jan 2014)

School-located influenza vaccination reduces community risk for influenza and influenza-like illness emergency care visits.

  • Cuc H Tran,
  • Jonathan D Sugimoto,
  • Juliet R C Pulliam,
  • Kathleen A Ryan,
  • Paul D Myers,
  • Joan B Castleman,
  • Randell Doty,
  • Jackie Johnson,
  • Jim Stringfellow,
  • Nadia Kovacevich,
  • Joe Brew,
  • Lai Ling Cheung,
  • Brad Caron,
  • Gloria Lipori,
  • Christopher A Harle,
  • Charles Alexander,
  • Yang Yang,
  • Ira M Longini,
  • M Elizabeth Halloran,
  • J Glenn Morris,
  • Parker A Small

DOI
https://doi.org/10.1371/journal.pone.0114479
Journal volume & issue
Vol. 9, no. 12
p. e114479

Abstract

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School-located influenza vaccination (SLIV) programs can substantially enhance the sub-optimal coverage achieved under existing delivery strategies. Randomized SLIV trials have shown these programs reduce laboratory-confirmed influenza among both vaccinated and unvaccinated children. This work explores the effectiveness of a SLIV program in reducing the community risk of influenza and influenza-like illness (ILI) associated emergency care visits.For the 2011/12 and 2012/13 influenza seasons, we estimated age-group specific attack rates (AR) for ILI from routine surveillance and census data. Age-group specific SLIV program effectiveness was estimated as one minus the AR ratio for Alachua County versus two comparison regions: the 12 county region surrounding Alachua County, and all non-Alachua counties in Florida.Vaccination of ∼50% of 5-17 year-olds in Alachua reduced their risk of ILI-associated visits, compared to the rest of Florida, by 79% (95% confidence interval: 70, 85) in 2011/12 and 71% (63, 77) in 2012/13. The greatest indirect effectiveness was observed among 0-4 year-olds, reducing AR by 89% (84, 93) in 2011/12 and 84% (79, 88) in 2012/13. Among all non-school age residents, the estimated indirect effectiveness was 60% (54, 65) and 36% (31, 41) for 2011/12 and 2012/13. The overall effectiveness among all age-groups was 65% (61, 70) and 46% (42, 50) for 2011/12 and 2012/13.Wider implementation of SLIV programs can significantly reduce the influenza-associated public health burden in communities.