title: Effectiveness of school-based influenza vaccination.
abstract: BACKGROUND
  Vaccination of children in school is one strategy to reduce the spread of influenza in households and communities.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Most outcomes related to influenza-like illness were significantly lower in intervention-school households than in control-school households. (ClinicalTrials.gov number, NCT00192218.)
authors.affiliation: Department of Pediatrics, University of Maryland School of Medicine, 737 W. Lombard St., Baltimore, MD 21201, USA. jking@peds.umaryland.edu
authors.forename: James C
authors.initials: JC
authors.lastname: King
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Stoddard
authors.forename: Manjusha J
authors.initials: MJ
authors.lastname: Gaglani
authors.forename: Kristine A
authors.initials: KA
authors.lastname: Moore
authors.forename: Laurence
authors.initials: L
authors.lastname: Magder
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McClure
authors.forename: Judith D
authors.initials: JD
authors.lastname: Rubin
authors.forename: Janet A
authors.initials: JA
authors.lastname: Englund
authors.forename: Kathleen
authors.initials: K
authors.lastname: Neuzil
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005192:Family Health; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D008297:Male; D012572:School Health Services; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States; D014613:Vaccines, Attenuated
chemical_list: D007252:Influenza Vaccines; D014613:Vaccines, Attenuated