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. 2018 May 15;115(20):5151-5156.
doi: 10.1073/pnas.1802479115. Epub 2018 Apr 30.

Optimizing the impact of low-efficacy influenza vaccines

Pratha Sah  1 , Jan Medlock  2 , Meagan C Fitzpatrick  1   3 , Burton H Singer  4 , Alison P Galvani  1
Affiliations

Optimizing the impact of low-efficacy influenza vaccines

Pratha Sah et al. Proc Natl Acad Sci U S A. .

Abstract

The efficacy of influenza vaccines varies from one year to the next, with efficacy during the 2017-2018 season anticipated to be lower than usual. However, the impact of low-efficacy vaccines at the population level and their optimal age-specific distribution have yet to be ascertained. Applying an optimization algorithm to a mathematical model of influenza transmission and vaccination in the United States, we determined the optimal age-specific uptake of low-efficacy vaccine that would minimize incidence, hospitalization, mortality, and disability-adjusted life-years (DALYs), respectively. We found that even relatively low-efficacy influenza vaccines can be highly impactful, particularly when vaccine uptake is optimally distributed across age groups. As vaccine efficacy declines, the optimal distribution of vaccine uptake shifts toward the elderly to minimize mortality and DALYs. Health practitioner encouragement and concerted recruitment efforts are required to achieve optimal coverage among target age groups, thereby minimizing influenza morbidity and mortality for the population overall.

Keywords: DALY; age structured; hospitalization; mathematical model; vaccination.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.
Population impact of vaccination on (A) incidence, (B) hospitalizations, (C) mortality, and (D) DALYs when doses of a low-efficacy vaccine are distributed according to age-specific uptake typical in the United States.
Fig. 2.
Fig. 2.
Comparisons of the impact of low-efficacy influenza vaccines between optimal age-stratified uptake of 140 million vaccine doses and typical age-specific vaccine uptake. Uptake was optimized to avert (A) incidence, (B) hospitalizations, (C) deaths, and (D) overall disease burden, measured by DALYs. Error bars represent SEM.
Fig. 3.
Fig. 3.
Optimal age-stratified coverage of 140 million doses of a low-efficacy vaccine to minimize (A) incidence, (B) hospitalizations, (C) mortality, and (D) overall disease burden, measured in Disability Adjusted Life Years (DALYs). Bar widths are proportional to the size of each age group. Bar heights correspond to the median of 1,000 optimization runs.
See this image and copyright information in PMC

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