This article was downloaded by: [Western Kentucky University] On: 29 October 2014, At: 12:21 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

Journal of American College Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/vach20

Who Should Get Influenza Vaccine? a

John M. Dorman PhD & Allan J. Schwartz PhD a

b

Outreach and Public Relations , Stanford University , California, USA

b

Mental Health Section of Health Service , University of Rochester , New York, USA Published online: 09 Jul 2010.

To cite this article: John M. Dorman PhD & Allan J. Schwartz PhD (1992) Who Should Get Influenza Vaccine?, Journal of American College Health, 41:3, 133-133, DOI: 10.1080/07448481.1992.9936313 To link to this article: http://dx.doi.org/10.1080/07448481.1992.9936313

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EDITORIAL Who Should Get Influenza Vaccine? Downloaded by [Western Kentucky University] at 12:21 29 October 2014

John M. Dorman, PhD, and Allan J. Schwartz, PhD

T

he preceding article by Farley et al on the impact of influenza vaccination on respiratory illness at a boarding school raises some interesting questions. The first is whether an article on health in secondary schools is within the scope of the journal at all: The Journal of American College Health “provides a medium for the exchange of information relating to health in community colleges, colleges, and universities,” our guidelines say. A strict interpretation of this statement would exclude this article because it is not about health at a college but, rather, at a secondary school. Few, however, would argue that it relares to problems faced by residential colleges; because the article is well written and informative, the editors chose to include it. Cultures and serology studies have proved that influenza A and B were present on their campuses. A separate statistical question was raised by one reviewer: Is it valid to extrapolate the attack rate in the immunized group to the entire school population? Extrapolation depends upon the assumption that the attack rate determined for the period of observation remains constant over the period to which that rate is applied by extrapolation. That attack rate, however, depends upon the frequency of exposure to the pathogen. Whether, on average, the patterns of exposure for the first half of an outbreak versus the second half, as defined by time, are symmetrical is not as clear. If they are not symmetrical, then the attack rate that would be found in these two halves would not be comparable.

John M. Dorman is Director of Outreach and Public Relations at Stanford University in California, and A h J. Schwartz k chief of the Mental Health Section of the University of Rochester (New York) Health Service.

VOL 41, NOVEMBER 1992

The authors have determined conservative extrapolated values for the days of class missed. (Class days saved by persons who are considered to have been prevented from becoming ill are not used to enhance the benefits of vaccination.) All things considered, the approach to extrapolation used was felt to be acceptable from a statistical standpoint. A last and separate question, not addressed by the authors, is whether it is appropriate to vaccinate young, healthy adolescents and young adults if there is not enough vaccine to go around. The Centers for Disease Control (CDC) has recommended vaccine primarily to those at increased risk for influenza-related complications, specifically, those over 65 years and anyone with “chronic disorders of the pulmonary or cardiovascular systems, including . . . asthma.’’ Recommendations go on to say that, in addition, “physicians should administer . . vaccine to any person who wishes to reduce the chance of acquiring influenza infection. . . . Students . . . in institutional settings (eg, schools and colleges) may be considered for vaccination to minimize the disruption of routine activities during outbreaks.”’ Because of the media attention paid to the vaccine last fall, there was a groundswell of students, faculty, and staff at Stanford who desired to be vaccinated. With the large number of young, healthy individuals receiving vaccine, some of the elderly and chronically ill truly in need of the vaccine were not able to be vaccinated when supplies ran short. We need to be careful that our marketing program does not outstrip our ability to respond.

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Reference

1 . Centers for Disease Control. MMWR. 1991;40:4-5.

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Who should get influenza vaccine?

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