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. 2025 Mar;90(3):106443.
doi: 10.1016/j.jinf.2025.106443. Epub 2025 Feb 12.

Increasing child vaccination coverage can reduce influenza cases across age groups: An agent-based modeling study

Katherine V Williams  1 , Mary G Krauland  2 , Mary Patricia Nowalk  3 , Lee H Harrison  4 , John V Williams  5 , Mark S Roberts  2 , Richard K Zimmerman  3
Affiliations

Increasing child vaccination coverage can reduce influenza cases across age groups: An agent-based modeling study

Katherine V Williams et al. J Infect. 2025 Mar.

Abstract

Objectives: Availability of caregiver-administered nasal spray live attenuated influenza vaccine (LAIV) raises the potential for increased influenza vaccine uptake. Direct and indirect benefits (decreased influenza cases and hospitalizations) of increased uptake among school-age children may be realized across the age spectrum. We used an agent-based model to determine the extent to which increased vaccination of children might affect overall influenza epidemiology.

Methods: The Framework for Reproducing Epidemiological Dynamics (FRED) uses a population based on the US census and accounts for individual characteristics to estimate the effect of changes in parameters including vaccine uptake, on outcomes. We modeled increases in vaccine uptake among school-age children 5-17 years old on influenza cases and hospitalizations by age group.

Results: Increasing vaccination rates in school-aged children by 5%-15% decreased their symptomatic influenza cases by 3.2%-10.9%, and among all age groups by 3.3%-11.6%, corresponding to an estimated annual reduction in cases of 522,867-1,810,170 among school-age children and of 1,394,687-4,945,952 overall. Annual U.S. hospitalizations could decrease by as much as 49,977, with the greatest impact (23,258) in those ages 65 years and over.

Conclusions: The opportunity to increase vaccination coverage in school-age children using LAIV can have a positive impact across all ages.

Keywords: Disease transmission; Epidemiological models; Human; Infectious; Influenza; School age population; Vaccination.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Roberts, MS reports financial support was provided by Centers for Disease Control and Prevention. Nowalk, MP reports a relationship with Sanofi Pasteur that includes: funding grants. Zimmerman, RK reports a relationship with Sanofi Pasteur that includes: funding grants. Harrison, LH has consulted with Sanofi Pasteur, GSK, Pfizer, and Merck without compensation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1.
Fig. 1.
Influenza Model Schematic. Infected Symptomatic and Hospitalized represent states presented in data tables.
Fig. 2.
Fig. 2.
Estimation of reduction in total symptomatic influenza cases and hospitalizations in the US population with 5%, 10%, and 15% increased vaccination coverage in children ages 5-17 years and 40% vaccine effectiveness (VE). Diagonal shading represents additional benefit of 45% VE in ages 5-17 years.
See this image and copyright information in PMC

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