title: Optimizing influenza vaccine distribution.
abstract: The criteria to assess public health policies are fundamental to policy optimization. Using a model parametrized with survey-based contact data and mortality data from influenza pandemics, we determined optimal vaccine allocation for five outcome measures: deaths, infections, years of life lost, contingent valuation, and economic costs. We find that optimal vaccination is achieved by prioritization of schoolchildren and adults aged 30 to 39 years. Schoolchildren are most responsible for transmission, and their parents serve as bridges to the rest of the population. Our results indicate that consideration of age-specific transmission dynamics is paramount to the optimal allocation of influenza vaccines. We also found that previous and new recommendations from the U.S. Centers for Disease Control and Prevention both for the novel swine-origin influenza and, particularly, for seasonal influenza, are suboptimal for all outcome measures.
authors.affiliation: Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, New Haven, CT 06520-8034, USA. medlock@clemson.edu
authors.forename: Jan
authors.initials: J
authors.lastname: Medlock
authors.forename: Alison P
authors.initials: AP
authors.lastname: Galvani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control*; D006291:Health Policy; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D009980:Influenza A virus / Q000276:immunology; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000600:supply & distribution*; D007251:Influenza, Human / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control* / Q000635:transmission; D008875:Middle Aged; D015233:Models, Statistical; D014481:United States / Q000453:epidemiology; D014611:Vaccination; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines