Article: Spatial considerations for the allocation of pre-pandemic influenza vaccination in the United States

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TitleSpatial considerations for the allocation of pre-pandemic influenza vaccination in the United States
AuthorsWu, JT1
Riley, S1
Leung, GM1
Issue Date2007
PublisherThe Royal Society. The Journal's web site is located at http://www.pubs.royalsoc.ac.uk/index.cfm?page=1087
CitationProceedings Of The Royal Society B: Biological Sciences, 2007, v. 274 n. 1627, p. 2811-2817 [How to Cite?]
DOI: http://dx.doi.org/10.1098/rspb.2007.0893
AbstractThe impact of the next influenza pandemic may be mitigated by inducing immunity in individuals prior to the start of national epidemics using a pre-pandemic vaccine targeted against current avian influenza strains. The US Department of Health and Human Services (HHS) intends that pre-pandemic vaccines will be allocated to states in proportion to the size of their population in predefined priority groups, i.e. approximately pro-rata. We show that such an equitable policy is likely to be the least efficient in terms of the number of infections averted. We demonstrate that the potential benefits could be substantial if a fully discretionary policy is allowed, i.e. if some regions are allocated sufficient vaccines to achieve herd immunity while other regions are allocated no vaccine. Since such an inequitable policy may be impractical, we consider the sensitivity of an intermediate policy (in which 50% of the stockpile is allocated on a pro-rata basis) to key transmission uncertainties. The benefits of the 50% discretionary policy are sensitive to parameter values which cannot be known in advance. Therefore, despite substantial potential benefits of non-pro-rata policies, our results suggest that the current HHS policy of pro-rata allocation by state is a good compromise in terms of simplicity, robustness, equity and efficiency. © 2007 The Royal Society.
ISSN0962-8452
2011 Impact Factor: 5.415
2011 SCImago Journal Rankings: 0.400
DOIhttp://dx.doi.org/10.1098/rspb.2007.0893
ISI Accession Number IDWOS:000250555000005
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorWu, JT
dc.contributor.authorRiley, S
dc.contributor.authorLeung, GM
dc.date.accessioned2010-09-06T09:20:56Z
dc.date.available2010-09-06T09:20:56Z
dc.date.issued2007
dc.description.abstractThe impact of the next influenza pandemic may be mitigated by inducing immunity in individuals prior to the start of national epidemics using a pre-pandemic vaccine targeted against current avian influenza strains. The US Department of Health and Human Services (HHS) intends that pre-pandemic vaccines will be allocated to states in proportion to the size of their population in predefined priority groups, i.e. approximately pro-rata. We show that such an equitable policy is likely to be the least efficient in terms of the number of infections averted. We demonstrate that the potential benefits could be substantial if a fully discretionary policy is allowed, i.e. if some regions are allocated sufficient vaccines to achieve herd immunity while other regions are allocated no vaccine. Since such an inequitable policy may be impractical, we consider the sensitivity of an intermediate policy (in which 50% of the stockpile is allocated on a pro-rata basis) to key transmission uncertainties. The benefits of the 50% discretionary policy are sensitive to parameter values which cannot be known in advance. Therefore, despite substantial potential benefits of non-pro-rata policies, our results suggest that the current HHS policy of pro-rata allocation by state is a good compromise in terms of simplicity, robustness, equity and efficiency. © 2007 The Royal Society.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationProceedings Of The Royal Society B: Biological Sciences, 2007, v. 274 n. 1627, p. 2811-2817 [How to Cite?]
DOI: http://dx.doi.org/10.1098/rspb.2007.0893
dc.identifier.citeulike9564313
dc.identifier.doihttp://dx.doi.org/10.1098/rspb.2007.0893
dc.identifier.epage2817
dc.identifier.hkuros139415
dc.identifier.isiWOS:000250555000005
dc.identifier.issn0962-8452
2011 Impact Factor: 5.415
2011 SCImago Journal Rankings: 0.400
dc.identifier.issue1627
dc.identifier.pmid17785273
dc.identifier.scopuseid_2-s2.0-35848959760
dc.identifier.spage2811
dc.identifier.urihttp://hdl.handle.net/10722/86756
dc.identifier.volume274
dc.languageeng
dc.publisherThe Royal Society. The Journal's web site is located at http://www.pubs.royalsoc.ac.uk/index.cfm?page=1087
dc.publisher.placeUnited Kingdom
dc.relation.ispartofProceedings of the Royal Society B: Biological Sciences
dc.relation.referencesReferences in Scopus
dc.subject.meshDisease Outbreaks - prevention & control
dc.subject.meshHealth Policy
dc.subject.meshHumans
dc.subject.meshImmunization Programs
dc.subject.meshInfluenza Vaccines
dc.subject.meshInfluenza, Human - prevention & control
dc.subject.meshRisk Factors
dc.subject.meshUnited States
dc.subject.meshUnited States Dept. of Health and Human Services
dc.titleSpatial considerations for the allocation of pre-pandemic influenza vaccination in the United States
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong