Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas 77030, USA.
J Infect Dis. 2010 Dec 1;202(11):1626-33. doi: 10.1086/657089. Epub 2010 Oct 28.
Influenza is an uncontrolled epidemic disease that is vaccine preventable. New recommendations for universal immunization present a challenge to the implementation of vaccine delivery. This field trial examines the effectiveness of school-based clinics for vaccine delivery before an epidemic caused by 3 new influenza virus variants not contained in the vaccine.
Live attenuated influenza vaccine (LAIV) was offered to eligible children in elementary schools of eastern Bell County, Texas. Age-specific rates of medically attended acute respiratory illness for health plan members at the intervention site were compared with those for members at comparison sites during the epidemic, defined by viral surveillance at all sites.
Almost 48% of children in elementary schools were vaccinated. Significant herd protection attributed to LAIV was detected for all age groups except 12-17-year-old students, who were not offered free vaccine. Approximately 2500 medical encounters were prevented at the intervention site. Inactivated vaccine provided marginal protection against the epidemic viruses.
LAIV delivered to elementary-school children before an epidemic caused by 3 new variant influenza viruses generated significant cross-protection for the recipients and indirect (herd) protection for the community.
流感是一种无法控制的传染病，可以通过疫苗预防。新的普遍免疫建议对疫苗接种的实施提出了挑战。本现场试验研究了在新的 3 种流感病毒变异株引起的疫情爆发之前，通过学校诊所进行疫苗接种的效果，这些变异株不在疫苗范围内。
在德克萨斯州东贝尔县的小学为符合条件的儿童提供减毒活流感疫苗（LAIV）。在疫情期间，通过所有地点的病毒监测来定义，将干预点的符合条件的健康计划成员的医疗保健机构就诊的急性呼吸道疾病的年龄特异性发病率与比较点的成员的发病率进行比较。
几乎 48%的小学生接种了疫苗。除了未提供免费疫苗的 12-17 岁学生外，LAIV 为所有年龄组的人群提供了显著的群体保护作用。在干预点大约预防了 2500 例医疗接触。灭活疫苗对流行病毒提供了轻微的保护作用。
在由 3 种新型流感病毒变异株引起的疫情爆发之前，为小学生接种 LAIV 为接种者提供了显著的交叉保护作用，并为社区提供了间接（群体）保护作用。
