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Effectiveness of Different Vaccine Allocation Strategies

Effectiveness of Different Vaccine Allocation Strategies. M. Elizabeth Halloran Center for Statistical and Quantitative Infectious Diseases University of Washington Hutchinson Research Center Seattle Washington August 18, 2009 . Timing: epidemic peak and vaccine supply.

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Effectiveness of Different Vaccine Allocation Strategies

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  1. Effectiveness of Different Vaccine Allocation Strategies M. Elizabeth Halloran Center for Statistical and Quantitative Infectious Diseases University of Washington Hutchinson Research Center Seattle Washington August 18, 2009

  2. Timing: epidemic peak and vaccine supply Information taken from NBSB teleconference August 14, 2009 assuming 2 doses per person

  3. Strategy: children first vs universalOne dose followed by second dose

  4. Expected vaccine efficacies (%) for inactivated seasonal influenza vaccine Basta NE, Halloran ME, Matrajt L, Longini IM. AJE (2008)

  5. Vaccine efficacy buildup assumption 1st dose, prime 2nd dose, boost

  6. Question: Two versus one dose policy? Two doses currently indicated, in question ACIP recommended providers continue to vaccinate unimmunized individuals and not keep vaccine in reserve for second dose. In these simulations, individuals get one dose, then three weeks later, they can compete to get a second dose with those receiving first dose. 6

  7. Epidemic curves: late October peak, R0=1.6

  8. Epidemic curves:late November and December peaks, R0=1.6

  9. Illness attack rate vs R0: late November and December peaks

  10. Illness attack rates (%)R0 = 1.6 10

  11. Summary Timing: The later the epidemic peak, the more effective current planned vaccine supply will be on reducing cases. If epidemic peak is late October, planned vaccine supply will have little effect. Strategy: Children first is better than universal vaccination in reducing cases 11

  12. Further Research Vaccinating groups at high risk of death with mortality as outcome Vaccinating other high priority groups: will use up vaccine likely with little effect on main transmission Age- and risk-group indications for specific vaccines Immunogenicity data to inform vaccine efficacy inputs USA simulations (here LA County only) Sensitivity analyses 12

  13. Open Questions Policy for first and second dose? Plans for evaluating efficacy in the field? Plans to use adjuvanted, antigen-sparing vaccines? How can we help BARDA? 13

  14. Our Flu Research Group Betz Halloran, Ira Longini Yang Yang Dennis Chao Eben Kenah Valerie Obenchain Jonathan Sugimoto Laura Matrajt Nicole Basta Gail Potter Rebecca Allen

  15. Information taken from NBSB teleconference on Aug.14, 2009. Vaccine production schedule

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