Influenza Virus Infection Clinical Trial
Official title:
A Randomised Controlled Trial of the Effectiveness of Vaccinating Children to Reduce Household Transmission of Influenza
While immunisation of school-age children against influenza is not recommended in Hong Kong, past experience in Japan and elsewhere suggests that immunisation of children may protect the wider community through its indirect transmission-limiting impact as well as the direct immunologic protection afforded vaccinated children themselves. We aim to assess whether vaccinating children against influenza protects vaccinees as well as their household contacts from infection.
Design and subjects: A double-blind randomised controlled trial of 800 subjects aged 6-17
drawn from the general population and their 2000 household contacts. The subjects will be
randomised in a 3:2 ratio to the intervention and placebo groups, respectively. Serum
samples will be collected from subjects pre- and 1 month post-vaccination, and after the
influenza season. Serum samples will be collected from household contacts at baseline and at
the end of the influenza season. During the follow-up period, subjects and household members
will keep symptom diaries and those reporting influenza-like-illness will be offered free
doctor consultations or home visits where we will arrange for collection of nose and throat
swabs.
Study instruments: An antibody titre of ≥40 in the post-vaccine serum will be used to define
seroprotection to those particular strains, while a four-fold or higher increase in antibody
titres between baseline and end-of-season follow-up of the household contacts will define
influenza infection during the season. Subjects and household contacts will be asked to keep
symptom diaries, and during episodes of ILI we will collect nose and throat swabs for
laboratory confirmation of influenza infection; the primary serology results will then be
compared with clinical and laboratory-confirmed influenza episodes.
Interventions: 1 (intervention) inactivated influenza vaccine (Vaxigrip, Sanofi Pasteur); 2
(placebo) saline injection.
Main outcome measures: The proportions of subjects and household contacts with
serology-confirmed influenza infection during follow-up among the 2 intervention arms.
Analysis: Intention to treat, adjusting for within-household correlation in influenza attack
rates.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Outcomes Assessor), Primary Purpose: Prevention
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