Prioritization of Influenza Pandemic Vaccination to Minimize Years of Life Lost

Mark Miller, Cecile Viboud, D.R. Olson, Rebecca Freeman Grais, Maia A. Rabaa, Lone Simonsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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.
OriginalsprogEngelsk
TidsskriftJournal of Infectious Diseases
Vol/bind198
Udgave nummer3
Sider (fra-til)305-311
ISSN0022-1899
StatusUdgivet - 2008

Citer dette

Miller, M., Viboud, C., Olson, D. R., Freeman Grais, R., Rabaa, M. A., & Simonsen, L. (2008). Prioritization of Influenza Pandemic Vaccination to Minimize Years of Life Lost. Journal of Infectious Diseases, 198(3), 305-311.
Miller, Mark ; Viboud, Cecile ; Olson, D.R. ; Freeman Grais, Rebecca ; Rabaa, Maia A. ; Simonsen, Lone. / Prioritization of Influenza Pandemic Vaccination to Minimize Years of Life Lost. I: Journal of Infectious Diseases. 2008 ; Bind 198, Nr. 3. s. 305-311.
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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.",
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Miller, M, Viboud, C, Olson, DR, Freeman Grais, R, Rabaa, MA & Simonsen, L 2008, 'Prioritization of Influenza Pandemic Vaccination to Minimize Years of Life Lost', Journal of Infectious Diseases, bind 198, nr. 3, s. 305-311.

Prioritization of Influenza Pandemic Vaccination to Minimize Years of Life Lost. / Miller, Mark; Viboud, Cecile; Olson, D.R.; Freeman Grais, Rebecca; Rabaa, Maia A.; Simonsen, Lone.

I: Journal of Infectious Diseases, Bind 198, Nr. 3, 2008, s. 305-311.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Prioritization of Influenza Pandemic Vaccination to Minimize Years of Life Lost

AU - Miller, Mark

AU - Viboud, Cecile

AU - Olson, D.R.

AU - Freeman Grais, Rebecca

AU - Rabaa, Maia A.

AU - Simonsen, Lone

PY - 2008

Y1 - 2008

N2 - 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.

AB - 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.

KW - influenza

KW - vaccination

KW - vaccines

KW - mortality

KW - elderly

KW - pandemic

M3 - Journal article

VL - 198

SP - 305

EP - 311

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 3

ER -

Miller M, Viboud C, Olson DR, Freeman Grais R, Rabaa MA, Simonsen L. Prioritization of Influenza Pandemic Vaccination to Minimize Years of Life Lost. Journal of Infectious Diseases. 2008;198(3):305-311.