To the Editor: The randomized study by Dr Loeb and colleagues1 of communities receiving either inactivated influenza vaccine or hepatitis A vaccine supports school-based influenza immunization and adds credence to a nationwide Japanese study that concluded that 1 life was saved for every 420 children immunized against influenza.2 The study by Loeb et al showed protection of community members against clinical illness, confirmed by real-time reverse transcriptase–polymerase chain reaction assay, but failed to show protection against infection as determined by hemagglutination inhibition titers. The authors speculated that “[o]ne possible explanation for the lack of significant differences in serologic outcomes is that the influenza vaccination may have attenuated infection that . . . rendered it subclinical but without preventing infection.”
Small PA, Morris JG. Influenza Vaccination of Children and Infection Rates in the Community. JAMA. 2010;303(23):2355–2356. doi:10.1001/jama.2010.779
* * SCHEDULED MAINTENANCE * *
The JAMA Network Sites will be conducting routine maintenance from 10/20/2017 through 10/21/2017. During this window access to content and authentication may be intermittently available. The JAMA Store will be completely unavailable during the maintenance window.