Optimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination.

For vaccine-preventable infections, immunization generally needs to be supplemented by palliative care of individuals missed by the vaccination. Costs and availability of vaccine doses and palliative care vary by disease and by region. In many situations, resources for delivery of palliative care ar...

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Autores principales:	Petra Klepac, Ottar N Bjørnstad, C Jessica E Metcalf, Bryan T Grenfell
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/aad2173aa46b46078ca9941dc4fe8513
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spelling	oai:doaj.org-article:aad2173aa46b46078ca9941dc4fe85132021-11-18T07:09:11ZOptimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination.1932-620310.1371/journal.pone.0041428https://doaj.org/article/aad2173aa46b46078ca9941dc4fe85132012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22899996/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203For vaccine-preventable infections, immunization generally needs to be supplemented by palliative care of individuals missed by the vaccination. Costs and availability of vaccine doses and palliative care vary by disease and by region. In many situations, resources for delivery of palliative care are independent of resources required for vaccination; however we also need to consider the conservative scenario where there is some trade-off between efforts, which is of potential relevance for resource-poor settings. We formulate an SEIR model that includes those two control strategies--vaccination and palliative care. We consider their relative merit and optimal allocation in the context of a highly efficacious vaccine, and under the assumption that palliative care may reduce transmission. We investigate the utility of a range of mixed or pure strategies that can be implemented after an epidemic has started, and look for rule-of-thumb principles of how best to reduce the burden of disease during an acute outbreak over a spectrum of vaccine-preventable infections. Intuitively, we expect the best strategy to initially focus on vaccination, and enhanced palliative care after the infection has peaked, but a number of plausible realistic constraints for control result in important qualifications on the intervention strategy. The time in the epidemic when one should switch strategy depends sensitively on the relative cost of vaccine to palliative care, the available budget, and R0. Crucially, outbreak response vaccination may be more effective in managing low-R0 diseases, while high R0 scenarios enhance the importance of routine vaccination and case management.Petra KlepacOttar N BjørnstadC Jessica E MetcalfBryan T GrenfellPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e41428 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Petra Klepac Ottar N Bjørnstad C Jessica E Metcalf Bryan T Grenfell Optimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination.
description	For vaccine-preventable infections, immunization generally needs to be supplemented by palliative care of individuals missed by the vaccination. Costs and availability of vaccine doses and palliative care vary by disease and by region. In many situations, resources for delivery of palliative care are independent of resources required for vaccination; however we also need to consider the conservative scenario where there is some trade-off between efforts, which is of potential relevance for resource-poor settings. We formulate an SEIR model that includes those two control strategies--vaccination and palliative care. We consider their relative merit and optimal allocation in the context of a highly efficacious vaccine, and under the assumption that palliative care may reduce transmission. We investigate the utility of a range of mixed or pure strategies that can be implemented after an epidemic has started, and look for rule-of-thumb principles of how best to reduce the burden of disease during an acute outbreak over a spectrum of vaccine-preventable infections. Intuitively, we expect the best strategy to initially focus on vaccination, and enhanced palliative care after the infection has peaked, but a number of plausible realistic constraints for control result in important qualifications on the intervention strategy. The time in the epidemic when one should switch strategy depends sensitively on the relative cost of vaccine to palliative care, the available budget, and R0. Crucially, outbreak response vaccination may be more effective in managing low-R0 diseases, while high R0 scenarios enhance the importance of routine vaccination and case management.
format	article
author	Petra Klepac Ottar N Bjørnstad C Jessica E Metcalf Bryan T Grenfell
author_facet	Petra Klepac Ottar N Bjørnstad C Jessica E Metcalf Bryan T Grenfell
author_sort	Petra Klepac
title	Optimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination.
title_short	Optimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination.
title_full	Optimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination.
title_fullStr	Optimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination.
title_full_unstemmed	Optimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination.
title_sort	optimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/aad2173aa46b46078ca9941dc4fe8513
work_keys_str_mv	AT petraklepac optimizingreactiveresponsestooutbreaksofimmunizinginfectionsbalancingcasemanagementandvaccination AT ottarnbjørnstad optimizingreactiveresponsestooutbreaksofimmunizinginfectionsbalancingcasemanagementandvaccination AT cjessicaemetcalf optimizingreactiveresponsestooutbreaksofimmunizinginfectionsbalancingcasemanagementandvaccination AT bryantgrenfell optimizingreactiveresponsestooutbreaksofimmunizinginfectionsbalancingcasemanagementandvaccination
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Optimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination.

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