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Unformatted text preview: Volume 333 OCTOBER 5, 1995 Number 14 Copyright, 1995, by the Massachusetts Medical Society THE EFFECTIVENESS OF VACCINATION AGAINST INFLUENZA IN HEALTHY, WORKING ADULTS K RISTIN L. N ICHOL , M.D., M.P.H., A PRIL L IND , M.S., K AREN L. M ARGOLIS , M.D., M.P.H., M AUREEN M URDOCH , M.D., M.P.H., R ODNEY M C F ADDEN , M.D., M ERI H AUGE , R.N., S ANNE M AGNAN , M.D., P H .D., AND M ARI D RAKE , M.P.H. Abstract Background. Although inuenza causes sub- stantial morbidity and mortality in all age groups, current recommendations emphasize annual immunization for people at high risk for complications of inuenza. We conducted a double-blind, placebo-controlled trial of vac- cination against inuenza in healthy, working adults. Methods. In the fall of 1994, we recruited working adults from 18 to 64 years of age from in and around the MinneapolisSt. Paul area and randomly assigned them to receive either inuenza vaccine or placebo in- jections. The primary study outcomes included upper respiratory illnesses, absenteeism from work because of upper respiratory illnesses, and visits to physicians offices for upper respiratory illnesses. The economic benefits of vaccination were analyzed by estimating the direct and indirect costs associated with immunization and with upper respiratory illnesses. Results. We enrolled a total of 849 subjects. Base- line characteristics were similar in the two groups. Dur- ing the follow-up period, consisting of the 19941995 in- uenza season (December 1, 1994, through March 31, 1995), those who received the vaccine reported 25 per- cent fewer episodes of upper respiratory illness than those who received the placebo (105 vs. 140 episodes per 100 subjects, P 0.001), 43 percent fewer days of sick leave from work due to upper respiratory illness (70 vs. 122 days per 100 subjects, P 0.001), and 44 percent fewer visits to physicians offices for upper respiratory ill- nesses (31 vs. 55 visits per 100 subjects, P 0.004). The cost savings were estimated to be $46.85 per person vaccinated. Conclusions. Vaccination against inuenza has sub- stantial health-related and economic benefits for healthy, working adults. (N Engl J Med 1995;333:889-93.) From the Veterans Affairs Medical Center (K.L.N., A.L., M.M., M.H.), Hen- nepin County Medical Center (K.L.M., R.M.), and the University of Minnesota Medical School (K.L.N., A.L., K.L.M., M.M., R.M., S.M.), Minneapolis; Blue Plus, an affiliate of Blue Cross Blue Shield of Minnesota, Eagan (S.M.); and the American Lung Association of Minnesota, St. Paul (M.D.). Address reprint re- quests to Dr. Nichol at the Section of General Internal Medicine (111O), Veter- ans Affairs Medical Center, One Veterans Dr., Minneapolis, MN 55417....
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