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Press Release
Nasal Flu Vaccine Reduces Employee Absenteeism and Health Care Visits
MINNEAPOLIS, July 13, 1999 -- Researchers from the U.S. Department of Veterans Affairs (VA) and colleagues have found that a new flu vaccine, delivered via nasal mist, significantly reduced employee absenteeism, doctor’s office visits, and medication use in healthy, working adults. Results of their study appear in the July 14 issue of the Journal of the American Medical Association (JAMA).
"These findings show substantial benefits in a population not usually targeted for flu vaccine," said study leader Kristin L. Nichol, M.D., M.P.H., chief of medicine, Minneapolis VA Medical Center and professor of medicine, University of Minnesota. "We found that when you vaccinate healthy, working adults, good things happen."
More than 4,500 healthy, working adults, aged 18 to 64 years, participated in the study at 13 VA medical centers. Two-thirds (3,041) received one dose of the intranasal influenza vaccine (FluMist™) and the remaining third (1,520) received a placebo. Researchers monitored the participants from September 1997 through March 1998 and recorded all adverse events during that time period.
"Our study evaluated several key parameters which measure the personal and economic burden of disease, including lost work days, physician visits and use of both prescription and over-the-counter therapeutics," said Paul M. Mendelman, M.D., vice president, clinical research at Aviron, manufacturer of the vaccine and second author of the JAMA paper. "The findings underscore the importance of flu immunization among working adults."
Participants receiving the actual vaccine experienced 18.8 percent fewer severe febrile (feverish) illnesses (111 vs. 136.7 episodes per 1000 subjects), and a 23.6 percent reduction in upper respiratory tract illnesses associated with fever (92.4 vs. 121 episodes per 1000 subjects). The duration of severe febrile illnesses was reduced 27.3 percent (1021.1 vs. 1404.4 days of illness per 1000 subjects).
Although the economical effects have yet to be analyzed, influenza accounts for millions of work days loss and physician office visits each year. In this study, Nichol and colleagues found that illness-associated absenteeism and health care visits were significantly lower among those receiving the flu vaccine. Participants missed 17.9 percent fewer workdays due to severe febrile illnesses (154.6 vs. 188.3 per 1000 subjects) and 28.4 percent fewer days for febrile upper respiratory tract illnesses (107 vs. 148.4 per 1000 subjects). Health care provider visits were as much as 40.9 percent lower (23.8 vs. 40.3 per 1000 subjects). Also significant, vaccinated subjects experienced a 47 percent reduction in days of prescription antibiotic use and 28 percent fewer days use of over-the-counter medications due to severe febrile illnesses.
These recent findings follow a study published May, 1998 by co-author Dr. Robert B. Belshe and colleagues in the New England Journal of Medicine, which found the same vaccine to be safe and effective for children. Prior to that, Dr. Nichol and colleagues studied the general effectiveness of the injected flu vaccine in healthy, working adults. They found that vaccinated adults had 25 percent fewer episodes of upper respiratory illnesses (105 vs. 140 episodes per 100 subjects), 43 percent fewer days of sick leave used due to upper respiratory illness (70 vs. 122 days per 100 subjects), and 44 percent fewer visits to physicians’ offices for upper respiratory illness (31 vs. 55 visits per 100 subjects) when compared to the placebo group.
Another multi-center study, currently underway in VA, is examining the effectiveness of the nasal spray vaccine in combination with the flu shot in adults over 50 with chronic lung disease. Results are being compared to the effectiveness of the flu shot alone. Twenty VA medical centers are participating in the study led by Geoffrey J. Gorse, M.D., staff physician in St. Louis.
Co-authors of the JAMA paper include Dr. Mendelman, Kenneth P. Mallon, M.S., M.H.S., Lisa A. Jackson, M.D., M.P.H., Dr. Gorse, Dr. Belshe, W. Paul Glezen, M.D., and Janet Wittes, Ph.D. Their work was supported by Aviron and the National Institute of Allergy and Infectious Diseases.
VA research provides improved medical care for veterans, as well as the general population. Through its unique affiliation with medical schools, VA plays a crucial role in educating future physicians in research and clinically oriented areas.
EDITOR'S & REPORTERS NOTE: Dr. Kristin L. Nichol will be available for interviews to discuss the intranasal influenza vaccine study. Please contact Sharon Skoblik at (612) 725-2102. For additional assistance, contact Jim Blue at (212) 807-3429.
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