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Observational Study
. 2018 Mar 13;18(1):128.
doi: 10.1186/s12879-018-3025-9.

High vaccination coverage is associated with low epidemic level of seasonal influenza in elementary schools: an observational study in Matsumoto City, Japan

Mitsuo Uchida  1 , Minoru Kaneko  2 , Yoshihiko Hidaka  3 , Hiroshi Yamamoto  4 , Takayuki Honda  5 , Shouhei Takeuchi  6 , Masaya Saito  7 , Shigeyuki Kawa  2
Affiliations
Observational Study

High vaccination coverage is associated with low epidemic level of seasonal influenza in elementary schools: an observational study in Matsumoto City, Japan

Mitsuo Uchida et al. BMC Infect Dis. .

Abstract

Background: Influenza virus transmission may be prevented by infection control measures, including vaccination, wearing a mask, gargling with water, and hand washing. It is unclear, however, whether these measures affect influenza epidemics in school settings.

Methods: A prospective epidemiological survey in all public elementary schools in Matsumoto City, Japan, during the 2014/2015 season evaluated the number of diagnosed patients in each school and calculated the reproduction number of schoolchildren. At the end of the prospective survey, a cross-sectional survey evaluated the implementation of infection control measures in these schools. Both results were combined and associations among infection control measures including vaccination, mask wearing, hand washing, water gargling, and epidemic level were evaluated.

Results: Of the 13,217 schoolchildren in 29 schools, 2548 were diagnosed with seasonal influenza. A significant negative association was observed between vaccination coverage and reproduction number at each school, but not between other infection control measures and the reproduction number. A regression curve with exponential function was most predictive. At 0% vaccination, the reproduction number was estimated to be 1.39.

Conclusion: These findings provide evidence that high vaccination coverage was associated with reduced epidemic levels in schools and suggest the need for increased vaccination of schoolchildren.

Keywords: Epidemiology; Infection control measure; Reproduction number; Schoolchildren; Seasonal influenza.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol was reviewed and approved by the Medical Ethics Board of Shinshu University School of Medicine (approval number 2715). Because this study was performed anonymously and questionnaires were returned voluntarily, informed consent was not obtained from study subjects.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Association between infection control measures and reproduction number. a The proportion of subjects vaccinated showed a significant negative correlation with reproduction number (ρ = −0.413, p = 0.029). However, b mask wearing, c hand washing and d gargling with water were not significantly associated with reproduction number
Fig. 2
Fig. 2
Generalized linear regression model between vaccination coverage and reproduction number in schools. A generalized linear regression model (solid line) was more predictive of reproduction number (AIC = −74.55) than other regression curves. High vaccine coverage was associated with lower reproduction numbers among schools. Required vaccine coverage was determined in three vaccine efficacy levels (ε = 1.0, 0.75 and 0.5). As efficacy became smaller, the cross point between the regression curve and the dashed line moved rightwards, indicating that lower vaccine efficacy requires higher vaccine coverage in elementary schools
See this image and copyright information in PMC

References

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