Program of Biostatistics and Biomathematics, Fred HutchinsonCancer Center, Seattle, Washington, USA.
Pediatrics. 2012 Mar;129 Suppl 2:S63-7. doi: 10.1542/peds.2011-0737D.
The illness attack rate and annual morbidity caused by infection with influenza is high in schoolchildren. Because schoolchildren are 1 of the most important sources of community-wide transmission of influenza, vaccinating them could have a major effect on reducing morbidity and mortality in older adults. Stochastic modeling shows that a vaccination rate as low as 20% in schoolchildren reduces overall mortality in adults aged ≥64 years more effectively than a vaccination rate of 90% for older adults. Additional modeling shows that vaccinating schoolchildren against influenza is optimal for reducing morbidity and mortality caused by influenza in the overall population. Although supported by simulated models, the benefits of mass vaccination need to be confirmed in a real-world setting. The best way to demonstrate the effectiveness of mass vaccination of schoolchildren is to implement the process in several localities in several states by using properly designed studies that incorporate accurate viral surveillance with at least 10 pairs of intervention and comparison populations.
流感感染导致的疾病发病率和年度发病率在学龄儿童中较高。由于学龄儿童是流感在社区范围内传播的最重要来源之一，因此为他们接种疫苗可能会对降低老年人的发病率和死亡率产生重大影响。随机模型表明，学龄儿童的疫苗接种率即使低至 20%，也比为老年人接种 90%的疫苗更有效地降低≥64 岁成年人的总体死亡率。额外的建模表明，为学龄儿童接种流感疫苗是降低整个人群因流感导致的发病率和死亡率的最佳方法。尽管得到了模拟模型的支持，但大规模接种疫苗的好处仍需要在真实环境中得到证实。证明大规模接种学龄儿童疫苗有效性的最佳方法是在几个州的几个地方实施该过程，方法是采用设计合理的研究，对至少 10 对干预和对照人群进行准确的病毒监测。
