Elementary school-based influenza vaccination: evaluating impact on respiratory illness absenteeism and laboratory-confirmed influenza.
Elementary school-based influenza vaccination: evaluating impact on respiratory illness absenteeism and laboratory-confirmed influenza.
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DOI：
10.1371/journal.pone.0072243
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Belongia EA
中科院分区：
文献类型：
--
作者：
Kjos SA;Irving SA;Meece JK;Belongia EA
对学校流感疫苗有效性的研究评估了所有原因的缺勤，而不是实验室确认的流感。我们进行了一项观察性试点研究，以确定由于呼吸道疾病和实验室确诊的流感在学校接种和未接种疫苗的学校缺席。2010年10月，一家当地公共卫生机构在威斯康星州的两所小学（暴露学校）启动了以学校为基础的流感疫苗接种;附近的两所学校作为对照组（非暴露学校）。对因发热或咳嗽疾病而缺勤的患者进行12周监测。在流感活动高峰期的4周内，联系了因发热/咳嗽疾病缺席儿童的父母，并提供了流感检测。在1,640名学生中，有937名（57%）获得了家长同意分享缺勤数据。52%和28%，分别在接触和非接触学校的所有学生接种疫苗。在12个监测周中的7个监测周中，暴露学校因发烧或咳嗽疾病而缺勤的人数明显较低。暴露学校的27%和未暴露学校的39%的学生因发烧/咳嗽疾病缺席一天或多天（p<0.0001）。学生因其他原因缺席的比例没有显著差异（p = 0.23）。 在4周的流感检测期间，163例因发热或咳嗽疾病缺席的患者中有68例（42%）获得了呼吸道样本。6名学生被检测出流感; 3名学生就读于暴露的学校。在学校中检测实验室确认的流感具有挑战性，因为需要多个同意书，难以从缺席的儿童中获得样本，以及流感季节温和。以学校为基础的流感疫苗接种与减少因发烧或咳嗽疾病而缺勤有关，但与其他原因缺勤无关。虽然没有特异性，但如果实验室确认的流感不可行，则因发热或咳嗽疾病而缺席可能是基于学校的研究中有用的替代终点。
Studies of influenza vaccine effectiveness in schools have assessed all-cause absenteeism rather than laboratory-confirmed influenza. We conducted an observational pilot study to identify absences due to respiratory illness and laboratory-confirmed influenza in schools with and without school-based vaccination. A local public health agency initiated school-based influenza vaccination in two Wisconsin elementary schools during October 2010 (exposed schools); two nearby schools served as a comparison group (non-exposed schools). Absences due to fever or cough illness were monitored for 12 weeks. During the 4 weeks of peak influenza activity, parents of absent children with fever/cough illness were contacted and offered influenza testing. Parental consent for sharing absenteeism data was obtained for 937 (57%) of 1,640 students. Fifty-two percent and 28%, respectively, of all students in exposed and non-exposed schools were vaccinated. Absences due to fever or cough illness were significantly lower in the exposed schools during seven of 12 surveillance weeks. Twenty-seven percent of students at exposed schools and 39% at unexposed schools had one or more days of absence due to fever/cough illness (p<0.0001). There was no significant difference in the proportion of students absent for other reasons (p = 0.23). During the 4 week period of influenza testing, respiratory samples were obtained for 68 (42%) of 163 episodes of absence due to fever or cough illness. Influenza was detected in 6 students; 3 attended exposed schools. Detection of laboratory-confirmed influenza in schools was challenging due to multiple consent requirements, difficulty obtaining samples from absent children, and a mild influenza season. School-based influenza vaccination was associated with reduced absenteeism due to fever or cough illness, but not absenteeism for other reasons. Although nonspecific, absence due to fever or cough illness may be a useful surrogate endpoint in school-based studies if identification of laboratory confirmed influenza is not feasible.
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