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

• Published in: BMC infectious diseases Vol. 18; no. 1; pp. 128 - 7
• Main Authors: Uchida, Mitsuo, Kaneko, Minoru, Hidaka, Yoshihiko, Yamamoto, Hiroshi, Honda, Takayuki, Takeuchi, Shouhei, Saito, Masaya, Kawa, Shigeyuki
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 13.03.2018; BioMed Central; BMC
• Subjects: Care and treatment; Child; Cities; Elementary school students; Epidemics; Epidemiology; Female; Health aspects; Humans; Infection Control; Infection control measure; Influenza; Influenza vaccines; Influenza Vaccines - immunology; Influenza, Human - diagnosis; Influenza, Human - epidemiology; Influenza, Human - prevention & control; Japan; Japan - epidemiology; Linear Models; Male; Prevention; Prospective Studies; Reproduction number; Schoolchildren; Schools; Seasonal influenza; Seasons; Surveys and Questionnaires; Vaccination Coverage; Japan; Seasonal influenza; Schoolchildren; Epidemiology; Reproduction number; Infection control measure
• DOI: 10.1186/s12879-018-3025-9
• ISSN: 1471-2334

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. 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. 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. 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.