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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
2012 Impact Factor: 5.683
2012 SCImago Journal Rankings: 2.423
 
DOIhttp://dx.doi.org/10.1098/rspb.2007.0893
 
ISI Accession Number IDWOS:000250555000005
 
ReferencesReferences in Scopus
 
DC FieldValue
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
2012 Impact Factor: 5.683
2012 SCImago Journal Rankings: 2.423
 
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
 
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Author Affiliations
  1. The University of Hong Kong