Effect of Influenza Vaccination of Children on Infection Rate in Hutterite Communities: Follow-Up Study of a Randomized Trial.

Autor: Wang B; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada., Russell ML; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada., Moss L; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada., Fonseca K; Department of Microbiology and Infectious Diseases and Provincial Laboratory for Public Health, University of Calgary, Calgary, Alberta, Canada., Earn DJ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.; Michael G. De- Groote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada.; Department of Mathematics and Statistics, McMaster University, Hamilton, Ontario, Canada., Aoki F; Departments of Medicine, Medical Microbiology and Pharmacology, and Therapeutics, University of Manitoba, Winnipeg, Manitoba, Canada., Horsman G; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan, Canada., Caeseele PV; Cadham Provincial Laboratory, Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada., Chokani K; Saskatchewan Health, Prince Albert Parkland Health Region, Prince Albert, Saskatchewan, Canada., Vooght M; Saskatchewan Health, Five Hills Health Region, Moose Jaw, Saskatchewan, Canada., Babiuk L; Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada., Webby R; St Jude Children's Research Hospital and WHO Collaborating Center, Memphis, Tennessee, United States of America., Walter SD; Department of Microbiology and Infectious Diseases and Provincial Laboratory for Public Health, University of Calgary, Calgary, Alberta, Canada., Loeb M; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.; Michael G. De- Groote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada.; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2016 Dec 15; Vol. 11 (12), pp. e0167281. Date of Electronic Publication: 2016 Dec 15 (Print Publication: 2016).
DOI: 10.1371/journal.pone.0167281
Abstrakt: Background: An earlier cluster randomized controlled trial (RCT) of Hutterite colonies had shown that if more than 80% of children and adolescents were immunized with influenza vaccine there was a statistically significant reduction in laboratory-confirmed influenza among all unimmunized community members. We assessed the impact of this intervention for two additional influenza seasonal periods.
Methods: Follow-up data for two influenza seasonal periods of a cluster randomized trial involving 1053 Canadian children and adolescents aged 36 months to 15 years in Season 2 and 1014 in Season 3 who received the study vaccine, and 2805 community members in Season 2 and 2840 in Season 3 who did not receive the study vaccine. Follow-up for Season 2 began November 18, 2009 and ended April 25, 2010 while Season 3 extended from December 6, 2010 and ended May 27, 2011. Children were randomly assigned in a blinded manner according to community membership to receive either inactivated trivalent influenza vaccine or hepatitis A. The primary outcome was confirmed influenza A and B infection using RT-PCR assay. Due to the outbreak of 2009 H1N1 pandemic, data in Season 2 were excluded for analysis.
Results: For an analysis of the combined Season 1 and Season 3 data, among non-recipients (i.e., participants who did not receive study vaccines), 66 of the 2794 (2.4%) participants in the influenza vaccine colonies and 121 of the 2301 (5.3%) participants in the hepatitis A colonies had influenza confirmed by RT-PCR, for a protective effectiveness of 60% (95% CI, 6% to 83%; P = 0.04); among all study participants (i.e., including both those who received study vaccine and those who did not), 125 of the 3806 (3.3%) in the influenza vaccine colonies and 239 of the 3243 (7.4%) in the hepatitis A colonies had influenza confirmed by RT-PCR, for a protective effectiveness of 63% (95% CI, 5% to 85%; P = 0.04).
Conclusion: Immunizing children and adolescents with inactivated influenza vaccine can offer a protective effect among unimmunized community members for influenza A and B together when considered over multiple years of seasonal influenza.
Trial Registration: Clinicaltrials.gov NCT00877396.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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