Vaccination against Influenza in Healthy Adults

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Abstract
Nichol et al. (Oct. 5 issue)1 report that during one influenza season, immunization against influenza significantly reduced the frequency of respiratory illness in healthy, working adults. About three quarters of the subjects had not previously been immunized. Our concern is whether subsequent influenza shots given annually would be as effective as they are the first time they are administered. Hoskins et al.2 studied the effectiveness of annual vaccinations against influenza at a boys' boarding school and found that over a four-year period, the cumulative attack rate for three successive outbreaks (approximately 40 to 50 percent) was the same irrespective of whether the subjects had received zero, one, two, or three vaccinations. Perhaps more important, the protective effect of vaccination appeared to be limited to boys receiving the vaccine for the first time. Our own observations were that during the last winter of type A Asian (H2N2) influenza activity (1967–1968), influenza shots were only 27 percent effective,3 whereas a year later — during the first year of Hong Kong (H3N2) influenza activity — shots were over 90 percent effective.4

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