School vaccination program reduces spread of influenza

February 1, 2007

Households where students who were offered free influenza immunization at school experienced less influenza and fewer influenza-related outcomes than the households where students who were not offered the school-based immunizations, a recent report found.

Investigators identified 11 demographically similar elementary-school clusters in four states. They assigned one school in each two- or three-school cluster to participate in a vaccination program (intervention school), while the other(s) did not have such a program (control schools). In the intervention schools, live attenuated influenza vaccine was offered at no charge to all healthy children 5 years or older in the fall of 2004. In the control schools, the vaccine was not offered, but children in these schools and other members of their households could receive influenza vaccination through their regular health-care provider, as could household members of children in the intervention schools. To determine the effects of the vaccine program, investigators compared influenza-related outcomes in the intervention schools and control schools in each cluster during one week in 2005 for which peak influenza activity had been predicted.

Almost half (47%) of students in intervention schools received the offered vaccine. Most outcomes related to influenza-like illness were significantly lower in intervention-school households than in control-school households: number of reported episodes of influenza-like symptoms, reported rates of illness in the household, number of reported episodes of fever plus cough or sore throat in children and adults, use of any medications for influenza-like illness, number of visits to doctors or clinics for influenza-like illness, and absentee rates for influenza-like illness among students in elementary school and high school and in the workplace (King JC et al: N Engl J Med 2006;355:2523).

Influenza vaccination in the school setting makes sense to me. Your office is already a busy place during flu vaccine season. And it is easier to reach a large portion of children quickly in the school than one at a time in the office. This study shows that this approach could work, benefiting not only the vaccinated children, but others in their homes and school community.