Prioritization of influenza pandemic vaccination to minimize years of life lost.
J Infect Dis
; 198(3): 305-11, 2008 Aug 01.
Article
em En
| MEDLINE
| ID: mdl-18558871
ABSTRACT
BACKGROUND:
How to allocate limited vaccine supplies in the event of an influenza pandemic is currently under debate. Conventional vaccination strategies focus on those at highest risk for severe outcomes, including seniors, but do not consider (1) the signature pandemic pattern in which mortality risk is shifted to younger ages, (2) likely reduced vaccine response in seniors, and (3) differences in remaining years of life with age.METHODS:
We integrated these factors to project the age-specific years of life lost (YLL) and saved in a future pandemic, on the basis of mortality patterns from 3 historical pandemics, age-specific vaccine efficacy, and the 2000 US population structure.RESULTS:
For a 1918-like scenario, the absolute mortality risk is highest in people <45 years old; in contrast, seniors (those >or=65 years old) have the highest mortality risk in the 1957 and 1968 scenarios. The greatest YLL savings would be achieved by targeting different age groups in each scenario; people <45 years old in the 1918 scenario, people 45-64 years old in the 1968 scenario, and people >45 years old in the 1957 scenario.CONCLUSIONS:
Our findings shift the focus of pandemic vaccination strategies onto younger populations and illustrate the need for real-time surveillance of mortality patterns in a future pandemic. Flexible setting of vaccination priority is essential to minimize mortality.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vacinas contra Influenza
/
Surtos de Doenças
/
Vacinação
/
Influenza Humana
/
Planejamento em Saúde
/
Prioridades em Saúde
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Child, preschool
/
Humans
/
Infant
/
Middle aged
/
Newborn
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article