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. 2010 May 6;7(46):755-64.
doi: 10.1098/rsif.2009.0393. Epub 2009 Oct 14.

Distribution of vaccine/antivirals and the 'least spread line' in a stratified population

E Goldstein  1 , A Apolloni, B Lewis, J C Miller, M Macauley, S Eubank, M Lipsitch, J Wallinga
Affiliations

Distribution of vaccine/antivirals and the 'least spread line' in a stratified population

E Goldstein et al. J R Soc Interface. .

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.

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Figures

Figure 1.
Figure 1.
Each of the five graphs plots the average cumulative number of people infected up to each day for a given vaccination strategy. Black, no vaccination. The other four graphs represent different allocations with the coverage level of 20.1 per cent of the population. Blue, random allocation. Purple, 55 per cent going to adults, 45 per cent to children (distributed at random). Green, 40 per cent going to adults, 60 per cent to children. Red, optimal (dynamical) allocation.
Figure 2.
Figure 2.
Each of the four graphs plots the average cumulative number of people infected up to each day for a given vaccination strategy. Black, no vaccination. The other three graphs represent different allocations with the coverage level of 26 per cent of the population. Blue, random allocation. Red, optimal static allocation. Green, optimal dynamical allocation.
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