Influenza is a vaccine-preventable disease. However, influenza virus spreads among children in schools and daycare centers, then to families and communities, causing uncontrolled epidemics every winter. The United States Food and Drug Administration evaluated and approved an investigational live-attenuated, cold-adapted, trivalent influenza vaccine for licensure, for prevention of influenza in healthy children and healthy adults, 5 through 49 years of age. Could protection of healthy schoolchildren against influenza limit its spread and benefit society?
Get full access to this article
View all access options for this article.
References
1.
Centers for Disease Control and Prevention. Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2002;51(RR-3):1-31.
2.
Couch RB. Prevention and treatment of influenza. N Engl J Med. 2000;343:1778-1787.
3.
Thompson WW, Shay DK, Weintraub E, et al.Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289:179-186.
4.
Neuzil KM, Hohlbein RN, Yuwei Z. Illness among schoolchildren during influenza season. Arch Pediatr Adolesc Med. 2002;156:986.
5.
Patriarca PA. New options for prevention and control of influenza. JAMA. 1999;282:75-77.
6.
Glaser CA, Gilliam S, Thompson WM, et al.Medical care capacity for influenza outbreaks, Los Angeles. Emerg Infect Dis. 2002;8:569-574.
7.
Meltzer MI, Cox NJ, Fukuda K. The economic impact of pandemic influenza in the United States: priorities for intervention. Emerg Infect Dis. 1999;5:659-671.
Neuzil KM, Mellen BG, Wright PF, et al.The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med. 2000;342:225-231.
10.
Izurieta HS, Thompson WW, Kramarz P, et al.Influenza and the rates of hospitalization for respiratory disease among infants and young children. N Engl J Med. 2000;342:232-239.
11.
Gaglani MJ, Riggs MR, Kamenicky C, et al.A computerized reminder strategy is effective for annual influenza immunization of children with asthma or reactive airway disease. Pediatr Infect Dis J. 2001;20:1155-1160.
12.
Gaglani MJ. Rationale and approach to target children with asthma for annual influenza immunization. Semin Pediatr Infect Dis. 2002;13:97-103.
13.
Mendelman PM, Cordova J, Cho I. Safety, efficacy, and effectiveness of the influenza virus vaccine, trivalent, types A and B, live, cold-adapted (CAIV-T) in healthy children and adults. Vaccine. 2001;19:2221-2226.
14.
Piedra PA. Safety of the trivalent, cold-adapted influenza vaccine (CAIV-T) in children. Semin Pediatr Infect Dis. 2002;13:90-96.
15.
Belshe RB, Mendelman PM, Treanor J, et al.The efficacy of live attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine in children. N Engl J Med. 1998;338:1405-1412.
16.
Belshe RB, Gruber WC, Mendelman PM, et al.Efficacy of vaccination with live attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine against a variant (A/Sydney) not contained in the vaccine. J Pediatr. 2000;136:168-175.
17.
Belshe RB, Gruber WC, Mendelman PM, et al.Correlates of immune protection induced by live, attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine. J Infect Dis. 2000;181:1133-1137.
18.
Piedra PA, Yan L, Kotloff K, et al.Safety of the trivalent, cold-adapted influenza vaccine in preschool-aged children. Pediatrics. 2002;110:662.
19.
Gaglani MJ, Piedra PA, Riggs MW, et al.Safety of the trivalent, cold-adapted, influenza virus vaccine (CAIV-T) in a subgroup of children with history of mild intermittent wheezing/asthma/reactive airway disease (RAD) in a community-based, non-randomized, open-label trial [abstract 1382]. Presented at the Pediatric Academic Societies, Baltimore, Maryland; April 29, 2001.
20.
Piedra PA, Gaglani M, Herschler G, et al.Safety and effectiveness of the trivalent, cold-adapted influenza vaccine (CAIV-T) in children. In: Osterhaus ADME, ed. The World Congress on Options for the Control of Influenza IV. Amsterdam: Elsevier Science; 2001:939-943.
21.
Zangwill KM, Droge J, Mendelman P, et al.Prospective, randomized, placebo-controlled evaluation of the safety and immunogenicity of three lots of intranasal trivalent influenza vaccine among young children. Pediatr Infect Dis. 2001;20:740-746.
22.
King JC Jr, Fast PE, Zangwill KM, et al.Safety, vaccine virus shedding and immunogenicity of trivalent, cold-adapted, live attenuated influenza vaccine administered to human immunodeficiency virus-infected and noninfected children. Pediatr Infect Dis J. 2001;20:1124-1131.
23.
Redding G, Walker RE, Hessel C, et al.Safety and tolerability of cold-adapted influenza virus vaccine in children and adolescents with asthma. Pediatr Infect Dis J. 2002;21:44-48.
24.
Nichol KL, Mendelman PM, Mallon KP, et al.Effectiveness of live, attenuated, intranasal influenza virus vaccine in healthy, working adults: a randomized controlled trial. JAMA. 1999;282:137-144.
25.
Gaglani MJ, Piedra PA, Herschler GB, et al.Effectiveness of the trivalent, cold-adapted influenza virus vaccine (CAIV-T) against the 2000-01 influenza A (H1N1) epidemic in a community-based, non-randomized open-label trial in healthy children [abstract 1639]. Presented at the Pediatric Academic Societies, Baltimore, Maryland; May 6, 2002.
26.
White T, Lavoie S, Nettleman MD. Potential cost savings attributable to influenza vaccination of school-aged children. Pediatrics. 1999;103:e73.
27.
Cohen GM, Nettleman MD. Economic impact of influenza vaccination in preschool children. Pediatrics. 2000;106:973-976.
28.
Luce BR, Zangwill KM, Palmer CS, et al.Cost-effectiveness analysis of an intranasal influenza vaccine for the prevention of influenza in healthy children. Pediatrics. 2001;108:e24.
29.
Monto AS, Davenport FM, Napier JA, et al.Modification of an outbreak of influenza in Tecumseh, Michigan by vaccination of schoolchildren. J Infect Dis. 1970;122:16-25.
30.
Reichert TA, Sugaya N, Fedson DS, et al.The Japanese experience with vaccinating schoolchildren against influenza. N Engl J Med. 2001;344:889-896.
31.
Longini IM Jr, Halloran EM, Nizam A, et al.Estimation of the efficacy of live, attenuated influenza vaccine from a two-year, multi-center vaccine trial: implications for influenza epidemic control. Vaccine. 2000;18:1902-1909.
Jacobson RM, Poland GA. Universal vaccination of healthy children against influenza: a role for the cold-adapted intranasal influenza vaccine. Paediatr Drugs. 2002;4:65-71.
34.
Herschler G, Griffith M, Gelsthorpe J, et al.Patient enrollment into large, time sensitive trials. SoCRA Source. 2001:40.
35.
Grabenstein JD. Nasal influenza vaccine: a bridge to full-service vaccine delivery by pharmacists. J Am Pharm Assoc. 2001;41:473.
36.
Humiston SG, Iwane M, Schaffer SJ, et al.Physician perceptions of the feasibility of universal influenza vaccination for young children [abstract 907]. Presented at the Pediatric Academic Societies, Baltimore, Maryland; May 5, 2002.
