tetano
Editor, Senior Moderator
Vaccine. 2014 Dec 5. pii: S0264-410X(14)01597-7. doi: 10.1016/j.vaccine.2014.11.044. [Epub ahead of print]
Randomized evaluation of live attenuated vs. inactivated influenza vaccines in schools (relatives) pilot study: A cluster randomized trial.
Kwong JC1, Pereira JA2, Quach S2, Pellizzari R3, Dusome E3, Russell ML4, Hamid JS5, Feinberg Y2, Winter AL2, Gubbay JB6, Sirtonski B2, Moher D2, Sider D2, Finkelstein M7, Loeb M8; for the Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network (PCIRN) Program Delivery.
Author information
Abstract
BACKGROUND:
School-based influenza immunization can effectively address accessibility barriers, but injected inactivated influenza vaccines (IIV) may not be acceptable to some children and parents in school settings.
OBJECTIVES:
To better understand the feasibility of offering intranasal live attenuated influenza vaccines (LAIV) through schools, we assessed uptake, stakeholder acceptability, and cost of school-based delivery of LAIV compared to IIV.
METHODS:
We piloted an open-label cluster randomized trial involving 10 elementary schools in Peterborough, Ontario during the 2013-2014 influenza vaccination campaign. Schools were randomized to having students receive IIV or LAIV at publicly-funded school-based clinics organized by the local public health department. We measured the percentage of students vaccinated with at least one dose of influenza vaccine at school. Stakeholder acceptability was evaluated through a questionnaire of parents and interviews of public health department personnel and school principals. We compared the costs per dose of vaccine administered, including staff time and costs of vaccines and supplies.
RESULTS:
Single-dose influenza vaccine uptake was higher for the five schools offering LAIV than for the five offering IIV (19.3% vs. 12.2%, p=0.02). Interviews with nine school principals and five public health department personnel suggested that the clinics ran smoothly with little disruption to school routines, and that LAIV was associated with increased efficiency and calmer children. All interviewees cited unfamiliarity with LAIV and the study recruitment package length as potential reasons for low uptake. The cost per vaccine dose administered was $38.67 for IIV and $43.50 for LAIV.
CONCLUSIONS:
Use of LAIV in school-based clinics was associated with increased vaccine uptake and the perception among immunizing staff of reduced child anxiety, but also slightly higher vaccine administration costs, compared to IIV. However, uptake was low for both groups. More effective strategies to promote influenza vaccines and to obtain parent consent may improve vaccine uptake.
TRIAL REGISTRATION:
ClinicalTrials.gov NCT01995851.
FUNDING:
Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network.
Copyright ? 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
KEYWORDS:
Canada; Immunization Programs*; Influenza; Ontario; Parents*; Schools
PMID:
25488331
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25488331
Randomized evaluation of live attenuated vs. inactivated influenza vaccines in schools (relatives) pilot study: A cluster randomized trial.
Kwong JC1, Pereira JA2, Quach S2, Pellizzari R3, Dusome E3, Russell ML4, Hamid JS5, Feinberg Y2, Winter AL2, Gubbay JB6, Sirtonski B2, Moher D2, Sider D2, Finkelstein M7, Loeb M8; for the Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network (PCIRN) Program Delivery.
Author information
Abstract
BACKGROUND:
School-based influenza immunization can effectively address accessibility barriers, but injected inactivated influenza vaccines (IIV) may not be acceptable to some children and parents in school settings.
OBJECTIVES:
To better understand the feasibility of offering intranasal live attenuated influenza vaccines (LAIV) through schools, we assessed uptake, stakeholder acceptability, and cost of school-based delivery of LAIV compared to IIV.
METHODS:
We piloted an open-label cluster randomized trial involving 10 elementary schools in Peterborough, Ontario during the 2013-2014 influenza vaccination campaign. Schools were randomized to having students receive IIV or LAIV at publicly-funded school-based clinics organized by the local public health department. We measured the percentage of students vaccinated with at least one dose of influenza vaccine at school. Stakeholder acceptability was evaluated through a questionnaire of parents and interviews of public health department personnel and school principals. We compared the costs per dose of vaccine administered, including staff time and costs of vaccines and supplies.
RESULTS:
Single-dose influenza vaccine uptake was higher for the five schools offering LAIV than for the five offering IIV (19.3% vs. 12.2%, p=0.02). Interviews with nine school principals and five public health department personnel suggested that the clinics ran smoothly with little disruption to school routines, and that LAIV was associated with increased efficiency and calmer children. All interviewees cited unfamiliarity with LAIV and the study recruitment package length as potential reasons for low uptake. The cost per vaccine dose administered was $38.67 for IIV and $43.50 for LAIV.
CONCLUSIONS:
Use of LAIV in school-based clinics was associated with increased vaccine uptake and the perception among immunizing staff of reduced child anxiety, but also slightly higher vaccine administration costs, compared to IIV. However, uptake was low for both groups. More effective strategies to promote influenza vaccines and to obtain parent consent may improve vaccine uptake.
TRIAL REGISTRATION:
ClinicalTrials.gov NCT01995851.
FUNDING:
Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network.
Copyright ? 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
KEYWORDS:
Canada; Immunization Programs*; Influenza; Ontario; Parents*; Schools
PMID:
25488331
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25488331