In the United States, national influenza vaccine recommendations have
typically been based on the prevention of complications and death among high-risk
persons. More recent is the increasing awareness that above and beyond the
more severe individual medical consequences of influenza, enormous societal
economic costs are associated with disruptions due to school and work absences
and days of illness. In this issue of THE JOURNAL, Nichol et al1
report that use of a live, attenuated influenza virus (LAIV) vaccine, administered
by intranasal spray to healthy, working adults (a group without a routine
recommendation to receive influenza vaccine), was followed in the subsequent
influenza epidemic season by a significant reduction in severe febrile illness,
days lost from work, health care visits, and the medication use that accompanies
these illnesses. Are these findings important? From an individual, medical,
and public health point of view, the answer is clearly yes. Reductions in
febrile illnesses, defined in various ways, ranged from approximately 13%
to 27%, reductions in work days lost from 18% to 28%, and reductions in health
care visits from 25% to 41%.
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