18 Nov

Studies support flu vaccination in children, adults

first_imgDec 14, 2006 (CIDRAP News) – Two studies reported in today’s issue of the New England Journal of Medicine provide additional support for seasonal influenza immunization while shedding some light on questions about vaccination strategies and the efficacy of the vaccines.Both studies were conducted in the 2004-05 flu season, when the vaccine was not optimally matched to the circulating virus strains. One study suggested that school-based flu vaccination programs in four states reduced flu-like illnesses in schoolchildren’s households. The other indicated that inactivated flu vaccine showed good effectiveness in adults despite the imperfect match with circulating viruses.Multistate school-based studyIn the school-based study, researchers grouped 28 elementary schools from 4 states into 11 demographically similar clusters, each of which included one intervention school that offered the vaccine plus 1or 2 schools that served as controls.In the intervention schools the intranasal formulation of the live attenuated influenza vaccine (FluMist) was offered free of charge at school to all healthy children age 5 or older during the fall of 2004. The study was supported by MedImmune, maker of FluMist.Researchers sent questionnaires to the intervention and control groups’ homes after the predicted week of peak flu activity for each state, asking families about flu-like symptoms, medical visits, medications, and absences from school and work.At the intervention schools, 2,717 (47%) of 5,840 students received the vaccine. Ninety-five percent of 1,535 children who were eligible to receive a second dose received it. The average age of the vaccinated students was 7.9 years (range, 5 to 14).Researchers predicted the peak influenza week correctly at two sites and were within 2 to 4 weeks at the remaining sites.The results revealed that intervention-school households reported fewer flu-like symptoms during the peak illness week than control-school households. The use of medications and humidifiers was lower in the intervention households.The number of visits to doctors or medical clinics was also lower, but the two groups did not differ in the rate of emergency department visits. Hospitalization rates in the intervention-school households were significantly higher, however.School absenteeism rates in the peak flu activity week were significantly lower for elementary and high school students in the intervention schools, though not for middle school students. At intervention schools, unvaccinated students had higher absenteeism rates than their vaccinated counterparts. Also, parents of children in the intervention schools reported fewer work days missed because of flu-like illness.Safety results in this study were consistent with previous results with the live attenuated vaccine, the authors noted. Four serious events were noted in four students within 42 days after receiving the vaccine. Only one was judged to be possibly related to the vaccine. None of the students were hospitalized, and all events resolved completely.The authors concluded that the study shows the benefits of a population intervention. “Even though fewer than half of the children were vaccinated, important benefits were observed,” they write.Kristine Moore, MD, MPH, a coauthor of the study, said, “We’ve known from a number of studies that children are one of the main amplifiers for influenza.” She said the study shows that vaccinating children in schools can dampen the amplification process by reducing flu-like illness in their households.The researchers found that the intranasal vaccine was simple to administer in the schools, said Moore, who is medical director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of the CIDRAP Web site. “This wasn’t a feasibility study, but it showed that school based vaccination can work,” she said.Moore said the study findings add to ongoing public health discussions about vaccination strategies, which are complex and range from targeting high-risk populations to universal vaccination.In an accompanying editorial, two flu vaccine experts from the World Health Organization (WHO), Keiji Fukuda and Marie Paule Kieny, comment, “The findings strongly suggest, but do not conclusively demonstrate, that the vaccination of these children reduced the spread of influenza to their households and to other student populations.”Michigan study of vaccine effectivenessIn the second study, authors hoped to answer questions about how current vaccines perform when circulating virus strains differ from the strains used in the vaccine. The study group included 1,247 healthy adult Michigan residents. Participants were randomly assigned to receive the inactivated vaccine or a placebo by intramuscular injection or the live attenuated vaccine or a placebo by intranasal spray between October and December 2004.Researchers monitored subjects by phone or e-mail until April 2005, instructing them to contact the study staff whenever they had an illness with at least two respiratory or systemic signs or symptoms. Throat swabs were collected from participants during the surveillance period to identify flu cases and define the period of flu activity. Serum samples of patients with symptoms were also collected and tested against the circulating viruses. Flu cases were identified by three methods: cell culture, polymerase chain reaction (PCR), and serologic (antibody) studies.As the flu season progressed, researchers found that the type A(H3N2) virus had drifted from the strain included in seasonal vaccines and that an unanticipated strain of type B virus was circulating, in addition to the one included in the vaccines.The authors found that the absolute efficacy of the inactivated vaccine against both types of virus was 77% on the basis of cell-culture confirmation of cases, 75% on the basis of cell culture or real-time PCR case confirmation, and 67% with cell-culture or serologic confirmation of cases. Using the same assessment measures, the absolute efficacy values for the live attenuated vaccine were 57%, 48%, and 30%, respectively.The researchers say the efficacy differences between the two vaccines appeared to be related to reduced effectiveness of the live attenuated vaccine against type B viruses.Four serious adverse events occurred among the participants within 30 days of receiving the virus, but only one was considered possibly linked to the vaccine.The performance of the inactivated vaccine was surprising, the researchers write. “This result was somewhat unexpected, given problems reported in past years when antigenically drifted viruses were circulating,” they state, adding that the consistent results of all of the confirmation methods were reassuring.Also unexpected were the indications of reduced efficacy of the live attenuated vaccine, they write, because previous studies showed it to be effective in years when drifted strains circulated.Using antibody titers to confirm infection with influenza may overestimate the efficacy of the inactivated vaccine and underestimate the efficacy of the live attenuated vaccine, the authors propose. They observe that live attenuated vaccines have shown efficacy in children, even against drifted strains, but in adults the live vaccine may not provoke an adequate response because of past influenza infections.Even if the intranasal vaccine is less effective in adults, the authors write that it would still be useful as the United States moves toward universal vaccination strategies.”The live attenuated vaccine could also be useful in a pandemic, given that the population would have no preexisting antibodies for the virus, and one dose of the vaccine would be expected to protect against it,” they write.Fukuda and Kieny, in their editorial, say the findings indicate that the two types of vaccines confer similar protection against influenza A in healthy adults, but more research is needed to determine if the vaccines are similarly effective in other age-groups and to assess the effectiveness of the live vaccine against influenza B.The WHO experts note that some observers question whether the substantial efforts to produce and deliver flu vaccine each year are justified. “The answer is, unambiguously, yes,” they write. “Indeed, the critical public health question is not whether influenza vaccines should be used, but how they can be used to advantage.”King JC, Stoddard JJ, Gaglani MJ, et al. Effectiveness of school-based influenza vaccination. N Engl J Med 2006;355(24):2523-32 [Full text]Ohmit SE, Victor JC, Rotthoff JR, et al. Prevention of antigenically drifted influenza by inactivated and live attenuated vaccines. N Engl J Med 2006;355(24):2513-22 [Full text]Fukuda K, Kieny MP. Different approaches to influenza vaccination. (Editorial) N Engl J Med 2006;355(24):2586-7 [Full text]last_img read more

14 Aug

Students share their thoughts on the FCA weekend that was at the Rock Springs 4-H Camp

first_imgClick here for a larger version of picture: by Tracy McCue, Sumner Newscow — For years, the Fellowship of Christian Athletes of Wellington load a bus and travel north to the Rock Springs 4-H Camp, south of Junction City, to participate in a weekend filled with sports activities intermixed with bible teaching and life lessens.Last weekend, 30 high school and 15 middle school students from Wellington got into a van very early Saturday morning to make the trip.  Once there each camp participant was assigned a “huddle” for the weekend – in which a group will play basketball, volleyball, soccer, long base and a few others.The team with the best record at the end of the weekend won the “towel”.  Huddles also had huddle time which include discussions from the bible and life lessons.  Everyone meets together for meals and for chapel time.  Chapel is a time for praise/worship songs and the main speaker.  The speaker for the weekend was a man named Jason Epperson.The theme for the weekend was “All In” for Jesus.The following are some of the weekend proses written by a few of those attending: “This year is the first year I decided to do FCA. FCA Conference was an experience I will never forget. At first, I was pretty “iffy” about the whole thing on whether or not I wanted to go, but in reality, I really didn’t know what I had been missing out on until I got there. It makes me wish I would’ve gone since my freshman year. Talking in my huddle about Jesus and going to chapel really got to me. Jason was an incredible preacher, and his message really clicked and stuck with me.  It made me realize that as long as you have faith in God, and go ALL IN, anything is possible.” — Jon Ryberg. “I had the privilege of being able to attend FCA Conference for my third time. Not only was it a great experience but Wellington was the biggest school there with 40 students.  One of my favorite things about Conference is getting to grow closer to God with some of my classmates. One of the many speakers there spoke out to me the most. His message was that I am too blessed to be stressed and I shouldn’t be because God will help me through anything. So, I’ve challenged myself to give compliments and encourage multiple people throughout my day and to be a light in our hallways.” — McKenna Oathout. “FCA conference never seems to fail. It’s a chance to grow in your faith, better yourself as a person, and become closer with your classmates. The hype that the FCA huddle members bring back into the hallways after a long weekend at conference, is something no one can deny. Students without a doubt can tell God has made a difference in each of our lives. FCA allows students at WMS and WHS to meet new people, and really expand in your knowledge of our savior. We are so lucky to have a school district that allows our group to be based out of our schools, and we are so so grateful to have such a large Huddle with more that 40 students attending each week. Its awesome to see your classmates pumped about Jesus! The most comforting feeling in the world is to know that you don’t stand alone in your walk with God.” — Allison McCue.Follow us on Twitter. “This was my first year attending the FCA conference, yet I have been to many things with my youth group just like it so no I didn’t feel weird or out of place. I felt the exact opposite actually. This was one of the best experiences of my life. From my AWESOME huddle to the fun activities to the CRAAZZYY chants to the amazing chapel service, I never wanted to leave. This was a time for me to further my walk with God and and just grow closer to him, and it made it easier to do that having so many other Christians my age around. The theme this year was going “All In” for God and I truly believe that’s where I am in my walk with him. I have made life long friendships and I have became a better leader from this conference. Yes, JESUS IS THE BEST THING I EVER FELT, I GET CRUNK ALL BY MYSELF!! (One of our many chants) — Katie Ledbetter. 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Thank you for your input. 0 Vote up Vote down Guest · 306 weeks ago Sounds like a wonderful experience for Wellington youth, positive and inspirational. Thanks for sharing some of your feelings and keep up the good work. Everyone can use some kind of encouragement or simply a positive remark. Wellington has so many young role models! Report Reply 0 replies · active 306 weeks ago Post a new comment Enter text right here! Comment as a Guest, or login: Login to IntenseDebate Login to WordPress.com Login to Twitter Go back Tweet this comment Connected as (Logout) Email (optional) Not displayed publicly. Name Email Website (optional) Displayed next to your comments. Not displayed publicly. If you have a website, link to it here. Posting anonymously. Tweet this comment Submit Comment Subscribe to None Replies All new comments Comments by IntenseDebate Enter text right here! Reply as a Guest, or login: Login to IntenseDebate Login to WordPress.com Login to Twitter Go back Tweet this comment Connected as (Logout) Email (optional) Not displayed publicly. Name Email Website (optional) Displayed next to your comments. Not displayed publicly. If you have a website, link to it here. Posting anonymously. Tweet this comment Cancel Submit Comment Subscribe to None Replies All new commentslast_img read more