Strategies for pandemic and seasonal influenza vaccination of schoolchildren in the United States.
Strategies for pandemic and seasonal influenza vaccination of schoolchildren in the United States.
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DOI：
10.1093/aje/kwp237
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发表时间：
2009-09-15
影响因子：
5
通讯作者：
Longini IM Jr
中科院分区：
文献类型：
--
作者：
Basta NE;Chao DL;Halloran ME;Matrajt L;Longini IM Jr
为学龄儿童接种流感疫苗可以降低特定年龄和人群的疾病发病率。作者使用流感传播的随机模拟模型，评估了为美国儿童接种疫苗的策略，改变了疫苗类型、覆盖水平和再生数 R（典型原发病例产生继发病例的平均数量）。结果表明，为儿童接种疫苗可以在多种情况下大幅降低人群疾病发病率。对于给定的疫苗覆盖率水平，每个季节流感病例绝对减少幅度最大的情况是 R 值在 1.2 至 1.6 之间。当传播强度为低至中等时，为儿童接种疫苗的间接、总体和总体影响很强。随着传播强度的增加，间接影响迅速下降。在温和的流感季节（R = 1.1），通过为 70% 的儿童接种疫苗可以预防约 1900 万流感病例。最多可以预防近1亿例流感病例，具体取决于接种疫苗的儿童比例和传播强度。鉴于目前新型甲型流感 (H1N1) 在全球范围内的威胁，估计 R 为 1.4-1.6，卫生官员应考虑为儿童接种新型甲型流感 (H1N1) 和季节性流感疫苗的策略。
Vaccinating school-aged children against influenza can reduce age-specific and population-level illness attack rates. Using a stochastic simulation model of influenza transmission, the authors assessed strategies for vaccinating children in the United States, varying the vaccine type, coverage level, and reproductive number R (average number of secondary cases produced by a typical primary case). Results indicated that vaccinating children can substantially reduce population-level illness attack rates over a wide range of scenarios. The greatest absolute reduction in influenza illness cases per season occurred at R values ranging from 1.2 to 1.6 for a given vaccine coverage level. The indirect, total, and overall effects of vaccinating children were strong when transmission intensity was low to intermediate. The indirect effects declined rapidly as transmission intensity increased. In a mild influenza season (R = 1.1), approximately 19 million influenza cases could be prevented by vaccinating 70% of children. At most, nearly 100 million cases of influenza illness could be prevented, depending on the proportion of children vaccinated and the transmission intensity. Given the current worldwide threat of novel influenza A (H1N1), with an estimated R of 1.4–1.6, health officials should consider strategies for vaccinating children against novel influenza A (H1N1) as well as seasonal influenza.