Optimal pandemic influenza vaccine allocation strategies for the Canadian population.

<h4>Background</h4>The world is currently confronting the first influenza pandemic of the 21(st) century. Influenza vaccination is an effective preventive measure, but the unique epidemiological features of swine-origin influenza A (H1N1) (pH1N1) introduce uncertainty as to the best stra...

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Autores principales:	Ashleigh R Tuite, David N Fisman, Jeffrey C Kwong, Amy L Greer
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2010
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/577f1b4b83ab48b28bfda2eeb0e167d4
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spelling	oai:doaj.org-article:577f1b4b83ab48b28bfda2eeb0e167d42021-12-02T20:21:52ZOptimal pandemic influenza vaccine allocation strategies for the Canadian population.1932-620310.1371/journal.pone.0010520https://doaj.org/article/577f1b4b83ab48b28bfda2eeb0e167d42010-05-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20463898/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The world is currently confronting the first influenza pandemic of the 21(st) century. Influenza vaccination is an effective preventive measure, but the unique epidemiological features of swine-origin influenza A (H1N1) (pH1N1) introduce uncertainty as to the best strategy for prioritization of vaccine allocation. We sought to determine optimal prioritization of vaccine distribution among different age and risk groups within the Canadian population, to minimize influenza-attributable morbidity and mortality.<h4>Methodology/principal findings</h4>We developed a deterministic, age-structured compartmental model of influenza transmission, with key parameter values estimated from data collected during the initial phase of the epidemic in Ontario, Canada. We examined the effect of different vaccination strategies on attack rates, hospitalizations, intensive care unit admissions, and mortality. In all scenarios, prioritization of high-risk individuals (those with underlying chronic conditions and pregnant women), regardless of age, markedly decreased the frequency of severe outcomes. When individuals with underlying medical conditions were not prioritized and an age group-based approach was used, preferential vaccination of age groups at increased risk of severe outcomes following infection generally resulted in decreased mortality compared to targeting vaccine to age groups with higher transmission, at a cost of higher population-level attack rates. All simulations were sensitive to the timing of the epidemic peak in relation to vaccine availability, with vaccination having the greatest impact when it was implemented well in advance of the epidemic peak.<h4>Conclusions/significance</h4>Our model simulations suggest that vaccine should be allocated to high-risk groups, regardless of age, followed by age groups at increased risk of severe outcomes. Vaccination may significantly reduce influenza-attributable morbidity and mortality, but the benefits are dependent on epidemic dynamics, time for program roll-out, and vaccine uptake.Ashleigh R TuiteDavid N FismanJeffrey C KwongAmy L GreerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 5, Iss 5, p e10520 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ashleigh R Tuite David N Fisman Jeffrey C Kwong Amy L Greer Optimal pandemic influenza vaccine allocation strategies for the Canadian population.
description	<h4>Background</h4>The world is currently confronting the first influenza pandemic of the 21(st) century. Influenza vaccination is an effective preventive measure, but the unique epidemiological features of swine-origin influenza A (H1N1) (pH1N1) introduce uncertainty as to the best strategy for prioritization of vaccine allocation. We sought to determine optimal prioritization of vaccine distribution among different age and risk groups within the Canadian population, to minimize influenza-attributable morbidity and mortality.<h4>Methodology/principal findings</h4>We developed a deterministic, age-structured compartmental model of influenza transmission, with key parameter values estimated from data collected during the initial phase of the epidemic in Ontario, Canada. We examined the effect of different vaccination strategies on attack rates, hospitalizations, intensive care unit admissions, and mortality. In all scenarios, prioritization of high-risk individuals (those with underlying chronic conditions and pregnant women), regardless of age, markedly decreased the frequency of severe outcomes. When individuals with underlying medical conditions were not prioritized and an age group-based approach was used, preferential vaccination of age groups at increased risk of severe outcomes following infection generally resulted in decreased mortality compared to targeting vaccine to age groups with higher transmission, at a cost of higher population-level attack rates. All simulations were sensitive to the timing of the epidemic peak in relation to vaccine availability, with vaccination having the greatest impact when it was implemented well in advance of the epidemic peak.<h4>Conclusions/significance</h4>Our model simulations suggest that vaccine should be allocated to high-risk groups, regardless of age, followed by age groups at increased risk of severe outcomes. Vaccination may significantly reduce influenza-attributable morbidity and mortality, but the benefits are dependent on epidemic dynamics, time for program roll-out, and vaccine uptake.
format	article
author	Ashleigh R Tuite David N Fisman Jeffrey C Kwong Amy L Greer
author_facet	Ashleigh R Tuite David N Fisman Jeffrey C Kwong Amy L Greer
author_sort	Ashleigh R Tuite
title	Optimal pandemic influenza vaccine allocation strategies for the Canadian population.
title_short	Optimal pandemic influenza vaccine allocation strategies for the Canadian population.
title_full	Optimal pandemic influenza vaccine allocation strategies for the Canadian population.
title_fullStr	Optimal pandemic influenza vaccine allocation strategies for the Canadian population.
title_full_unstemmed	Optimal pandemic influenza vaccine allocation strategies for the Canadian population.
title_sort	optimal pandemic influenza vaccine allocation strategies for the canadian population.
publisher	Public Library of Science (PLoS)
publishDate	2010
url	https://doaj.org/article/577f1b4b83ab48b28bfda2eeb0e167d4
work_keys_str_mv	AT ashleighrtuite optimalpandemicinfluenzavaccineallocationstrategiesforthecanadianpopulation AT davidnfisman optimalpandemicinfluenzavaccineallocationstrategiesforthecanadianpopulation AT jeffreyckwong optimalpandemicinfluenzavaccineallocationstrategiesforthecanadianpopulation AT amylgreer optimalpandemicinfluenzavaccineallocationstrategiesforthecanadianpopulation
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Optimal pandemic influenza vaccine allocation strategies for the Canadian population.

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