title: Distribution of vaccine/antivirals and the 'least spread line' in a stratified population.
abstract: We describe a prioritization scheme for an allocation of a sizeable quantity of vaccine or antivirals in a stratified population. The scheme builds on an optimal strategy for reducing the epidemic's initial growth rate in a stratified mass-action model. The strategy is tested on the EpiSims network describing interactions and influenza dynamics in the population of Utah, where the stratification we have chosen is by age (0-6, 7-13, 14-18, adults). No prior immunity information is available, thus everyone is assumed to be susceptible-this may be relevant, possibly with the exception of persons over 50, to the 2009 H1N1 influenza outbreak. We have found that the top priority in an allocation of a sizeable quantity of seasonal influenza vaccinations goes to young children (0-6), followed by teens (14-18), then children (7-13), with the adult share being quite low. These results, which rely on the structure of the EpiSims network, are compared with the current influenza vaccination coverage levels in the US population.
authors.affiliation: Harvard School of Public Health, Boston, MA 02115, USA. egoldste@hsph.harvard.edu
authors.forename: E
authors.initials: E
authors.lastname: Goldstein
authors.forename: A
authors.initials: A
authors.lastname: Apolloni
authors.forename: B
authors.initials: B
authors.lastname: Lewis
authors.forename: J C
authors.initials: JC
authors.lastname: Miller
authors.forename: M
authors.initials: M
authors.lastname: Macauley
authors.forename: S
authors.initials: S
authors.lastname: Eubank
authors.forename: M
authors.initials: M
authors.lastname: Lipsitch
authors.forename: J
authors.initials: J
authors.lastname: Wallinga
mesh_terms: D000293:Adolescent; D000465:Algorithms; D000998:Antiviral Agents / Q000737:chemistry*; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D004196:Disease Outbreaks; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000378:metabolism*; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control; D014612:Vaccines / Q000737:chemistry
chemical_list: D000998:Antiviral Agents; D007252:Influenza Vaccines; D014612:Vaccines