Abstract
BackgroundCollege and university students experience substantial morbidity from influenza and influenza-like illness, and they can benefit substantially from vaccination. Public health authorities encourage vaccination not only before the influenza season but also into and even throughout the influenza season. We conducted the present study to assess the impact of various vaccination strategies including delayed (i.e., in-season) vaccination on influenza outbreaks on a college campus.Methods/FindingsWe used a Susceptible → Infected → Recovered (SIR) framework for our mathematical models to simulate influenza epidemics in a closed, college campus. We included both students and faculty/staff in the model and derived values for the model parameters from the published literature. The values for key model parameters were varied to assess the impact on the outbreak of various pre-season and delayed vaccination rates; one-way sensitivity analyses were conducted to test the sensitivity of the model outputs to changes in selected parameter values. In the base case, with a pre-season vaccination rate of 20%, no delayed vaccination, and 1 student index case, the total attack rate (total percent infected, TAR) was 45%. With higher pre-season vaccination rates TARs were lower. Even if vaccinations were given 30 days after outbreak onset, TARs were still lower than the TAR of 69% in the absence of vaccination. Varying the proportions of vaccinations given pre-season versus delayed until after the onset of the outbreak gave intermediate TAR values. Base case outputs were sensitive to changes in infectious contact rates and infectious periods and a holiday/break schedule.ConclusionDelayed vaccination and holidays/breaks can be important adjunctive measures to complement traditional pre-season influenza vaccination for controlling and preventing influenza in a closed college campus.
Highlights
Influenza is a major cause of morbidity and mortality and each year causes tens of millions of illnesses, hundreds of thousands of excess hospitalizations, and tens of thousands of excess deaths in the US. [1] Vaccination remains the mainstay of efforts to prevent and control influenza, and in the US current recommendations for the use of influenza vaccines encourage all people to receive vaccination
[9] Influenza vaccination has been associated with significant reductions in influenza-like illnesses (ILIs) as well as ILI-associated impaired school performance and health care utilization, [10] and many college and university student health service programs have implemented influenza vaccination programs for their students and faculty
The Centers for Disease Control and Prevention and others are calling on providers to expand vaccination efforts into and even throughout the entire influenza season. [2] [11] [12]This strategy is urged in order to take advantage of opportunities to vaccinate people who might otherwise fail to receive their vaccine and to ensure demand for vaccine that might not become available until December or January
Summary
Influenza is a major cause of morbidity and mortality and each year causes tens of millions of illnesses, hundreds of thousands of excess hospitalizations, and tens of thousands of excess deaths in the US. [1] Vaccination remains the mainstay of efforts to prevent and control influenza, and in the US current recommendations for the use of influenza vaccines encourage all people to receive vaccination. While not included among the high priority groups for vaccination, college and university students may be at increased risk for influenza and influenza-like illnesses (ILIs). [3] [4] [5] [6] students experience substantial morbidity from influenza and ILIs. Outbreaks on campuses with high attack rates have been described. [3] [4] [5] [6] students experience substantial morbidity from influenza and ILIs On average they experience up to 8 days or more of illness along with increased rates of health care use, school absenteeism, and impaired academic performance for each ILI. Influenza vaccination programs, including those on college and university campuses, traditionally have been organized around vaccine delivery in October and November, strategies consistent with many years’ advice addressing the timing of vaccination programs from national authorities. We conducted the present study to assess the impact of various vaccination strategies including delayed (i.e., in-season) vaccination on influenza outbreaks on a college campus
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