Epidemic Intelligence Service, Assigned to Influenza Division (Now with Immunization Services Division), Centers for Disease Control and Prevention, Mailstop A-19, Atlanta, GA 30333, United States.
Vaccine. 2012 Jul 6;30(32):4835-41. doi: 10.1016/j.vaccine.2012.05.008. Epub 2012 May 17.
The overall and indirect effects of immunizing school children with influenza A (H1N1) 2009 pandemic virus vaccine prior to and during the peak of virus circulation were evaluated on student and teacher school absenteeism. We used records collected from late 2009 through early 2010 from schools in four Maine counties. Mixed logistic regression models were used to estimate the daily association between school-level immunization coverage and absenteeism by level of influenza activity, after adjusting for the proportion of students receiving reduced-cost lunches, student minority status, absences adjacent to weekends and Thanksgiving, rural school location, and the circulation of other respiratory viruses. Increasing student immunization coverage was associated with reduced absenteeism during periods of high influenza activity. For example, as immunization coverage during the peak week of pandemic virus circulation increased from 38% to 69% (the 10th and 90th percentiles of observed coverage, respectively), relative reductions in daily absenteeism among all students, unimmunized students, and teachers were 8.2% (95% confidence interval [CI]: 6.5, 9.9), 5.7% (95% CI: 4.2, 7.3), and 8.7% (95% CI: 1.3, 16), respectively. Increased vaccination coverage among school-aged Maine children had modest overall and indirect effects on student and teacher absenteeism, despite vaccination occurring just prior and during peak pandemic virus circulation.
在病毒传播高峰期之前和期间，对在校儿童进行甲型流感（H1N1）2009 大流行病毒疫苗免疫接种的总体和间接效果，评估了对学生和教师的缺课情况的影响。我们使用了 2009 年底至 2010 年初从缅因州四个县的学校收集的记录。在调整了接受低价午餐的学生比例、学生少数民族身份、与周末和感恩节相邻的缺勤、农村学校位置以及其他呼吸道病毒的流行情况后，我们使用混合逻辑回归模型来估计学校层面的免疫接种覆盖率与流感活动水平之间的每日关联。随着学生免疫接种率的增加，在流感活动高峰期缺勤率有所降低。例如，在大流行病毒传播高峰期的一周内，免疫接种率从 38%增加到 69%（分别为观察到的接种率的第 10 百分位和第 90 百分位），所有学生、未接种疫苗的学生和教师的日缺勤率相对减少了 8.2%（95%置信区间：6.5，9.9）、5.7%（95%置信区间：4.2，7.3）和 8.7%（95%置信区间：1.3，16）。尽管疫苗接种发生在大流行病毒传播高峰期之前和期间，但缅因州学龄儿童疫苗接种覆盖率的增加对学生和教师的缺勤情况产生了适度的总体和间接影响。
