Evaluating impact of school outreach vaccination programme in Hong Kong influenza season 2018 – 2019

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ABSTRACT

School-based vaccination, as a means to mitigate seasonal influenza outbreak, depends on attaining adequate coverage rate. We evaluated the potential of a fully subsidized school outreach vaccination (SOV) program to achieve epidemic prevention potential in Hong Kong. The purpose of this study was to evaluate the impact of SOV program 2018–2019 on influenza vaccination rates and influenza-like illness (ILI) in the primary school students and their household members during the influenza season. The vaccination rate was significantly higher in the schools offering SOV (intervention schools) (69.2% vs. 34.3%) than those not offering SOV (control schools) ( p < .0001). The ILI rate was significantly reduced from 14.1% among non-vaccinated to 7.7% among vaccinated students ( p < .0001). Influenza vaccine effectiveness against ILI was 45.3%. The vaccination rates of the household members were the same in both intervention and control schools except in the sub-group of preschool household members with the intervention significantly higher than the control group (43.8% vs. 32%, p < .0001). SOV program significantly improved influenza vaccine coverage, and the vaccine reduced ILI incidence. Extension of SOV program to all primary schools as well as kindergartens in Hong Kong could achieve epidemic prevention potential and should be evaluated.

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Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

Lisa Grohskopf, Leslie Sokolow, Karen Broder … (2018)

Summary This report updates the 2017–18 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2017;66[No. RR-2]). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. A licensed, recommended, and age-appropriate vaccine should be used. Inactivated influenza vaccines (IIVs), recombinant influenza vaccine (RIV), and live attenuated influenza vaccine (LAIV) are expected to be available for the 2018–19 season. Standard-dose, unadjuvanted, inactivated influenza vaccines will be available in quadrivalent (IIV4) and trivalent (IIV3) formulations. Recombinant influenza vaccine (RIV4) and live attenuated influenza vaccine (LAIV4) will be available in quadrivalent formulations. High-dose inactivated influenza vaccine (HD-IIV3) and adjuvanted inactivated influenza vaccine (aIIV3) will be available in trivalent formulations. Updates to the recommendations described in this report reflect discussions during public meetings of ACIP held on October 25, 2017; February 21, 2018; and June 20, 2018. New and updated information in this report includes the following four items. First, vaccine viruses included in the 2018–19 U.S. trivalent influenza vaccines will be an A/Michigan/45/2015 (H1N1)pdm09–like virus, an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus, and a B/Colorado/06/2017–like virus (Victoria lineage). Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage). Second, recommendations for the use of LAIV4 (FluMist Quadrivalent) have been updated. Following two seasons (2016–17 and 2017–18) during which ACIP recommended that LAIV4 not be used, for the 2018–19 season, vaccination providers may choose to administer any licensed, age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). LAIV4 is an option for those for whom it is appropriate. Third, persons with a history of egg allergy of any severity may receive any licensed, recommended, and age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). Additional recommendations concerning vaccination of egg-allergic persons are discussed. Finally, information on recent licensures and labeling changes is discussed, including expansion of the age indication for Afluria Quadrivalent (IIV4) from ≥18 years to ≥5 years and expansion of the age indication for Fluarix Quadrivalent (IIV4), previously licensed for ≥3 years, to ≥6 months. This report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2018–19 season in the United States. A Background Document containing further information and a brief summary of these recommendations are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html. These recommendations apply to U.S.-licensed influenza vaccines used within Food and Drug Administration–licensed indications. Updates and other information are available at CDC’s influenza website (https://www.cdc.gov/flu). Vaccination and health care providers should check CDC’s influenza website periodically for additional information.

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Effectiveness of school-based influenza vaccination.

Nicholas King, Elizabeth McClure, Manjusha Gaglani … (2006)

Vaccination of children in school is one strategy to reduce the spread of influenza in households and communities. We identified 11 demographically similar clusters of elementary schools in four states, consisting of one school we assigned to participate in a vaccination program (intervention school) and one or two schools that did not participate (control schools). During a predicted week of peak influenza activity in each state, all households with children in intervention and control schools were surveyed regarding demographic characteristics, influenza vaccination, and outcomes of influenza-like illness during the previous 7 days. In all, 47% of students in intervention schools received live attenuated influenza vaccine. As compared with control-school households, intervention-school households had significantly fewer influenza-like symptoms and outcomes during the recall week. Paradoxically, intervention-school households (both children and adults) had higher rates of hospitalization per 100 persons than did control-school households. However, there was no difference in the overall hospitalization rates for children or adults in households with vaccinated children, as compared with those with unvaccinated children, regardless of study-group assignment. Rates of school absenteeism for any cause (based on school records) were not significantly different between intervention and control schools. Most outcomes related to influenza-like illness were significantly lower in intervention-school households than in control-school households. (ClinicalTrials.gov number, NCT00192218.) 2006 Massachusetts Medical Society

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Evaluation of an influenza-like illness case definition in the diagnosis of influenza among patients with acute febrile illness in cambodia

Matthew Kasper, Thomas F. Wierzba, Ly Sovann … (2010)

Background Influenza-like illness (ILI) is often defined as fever (>38.0°C) with cough or sore throat. In this study, we tested the sensitivity, specificity, and positive and negative predictive values of this case definition in a Cambodia patient population. Methods Passive clinic-based surveillance was established at nine healthcare centers to identify the causes of acute undifferentiated fever in patients aged two years and older seeking treatment. Fever was defined as tympanic membrane temperature >38°C lasting more than 24 hours and less than 10 days. Influenza virus infections were identified by polymerase chain reaction. Results From July 2008 to December 2008, 2,639 patients were enrolled. From 884 (33%) patients positive for influenza, 652 presented with ILI and 232 acute fever patients presented without ILI. Analysis by age group identified no significant differences between influenza positive patients from the two groups. Positive predictive values (PPVs) varied during the course of the influenza season and among age groups. Conclusion The ILI case definition can be used to identify a significant percentage of patients with influenza infection during the influenza season in Cambodia, assisting healthcare providers in its diagnosis and treatment. However, testing samples based on the criteria of fever alone increased our case detection by 34%.

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Journal

Journal ID (nlm-ta): Hum Vaccin Immunother

Journal ID (iso-abbrev): Hum Vaccin Immunother

Journal ID (publisher-id): KHVI

Journal ID (publisher-id): khvi20

Title: Human Vaccines & Immunotherapeutics

Publisher: Taylor & Francis

ISSN (Print): 2164-5515

ISSN (Electronic): 2164-554X

Publication date Collection: 2020

Publication date (Electronic): 30 October 2019

Publication date PMC-release: 30 October 2019

Volume: 16

Issue: 4

Pages: 823-826

Affiliations

Department of Paediatrics and Adolescent Medicine, The University of Hong Kong , Pokfulam, Hong Kong

Author notes

CONTACT Yu-Lung Lau lauylung@ 123456hku.hk Department of Paediatrics and Adolescent Medicine, The University of Hong Kong , Pokfulam, Hong Kong

Author information

Yu Lung Lau http://orcid.org/0000-0002-4780-0289

Wilfred Hing Sang Wong http://orcid.org/0000-0001-8396-2368

Article

Publisher ID: 1678357

DOI: 10.1080/21645515.2019.1678357

PMC ID: 7227703

PubMed ID: 31596660

SO-VID: 72b37516-58db-46ed-9a18-3cb646336813

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.

History

Date received : 14 July 2019

Date revision received : 16 September 2019

Date accepted : 3 October 2019

Page count

Tables: 2, References: 20, Pages: 4

Funding

Funded by: Center for Health Protection 10.13039/100001535

Award ID: CHP-CE-11

This work was supported by the Health and Medical Research Fund [CHP-CE-11].

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Evaluating impact of school outreach vaccination programme in Hong Kong influenza season 2018 – 2019

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Most cited references 13

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

Effectiveness of school-based influenza vaccination.

Evaluation of an influenza-like illness case definition in the diagnosis of influenza among patients with acute febrile illness in cambodia

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