Giuseppe
Emeritus
Vaccination Deep Into a Pandemic Wave: Potential Mechanisms for a ?Third Wave? and the Impact of Vaccination (Am J Prev Med., abstract, edited)
[Source: American Journal of Preventive Medicine, full text: <cite cite="http://www.ajpm-online.net/article/PIIS0749379710004435/abstract?rss=yes">Vaccination Deep Into a Pandemic Wave: Potential Mechanisms for a ?Third Wave? and the Impact of Vaccination</cite>. Abstract, edited.]
Vaccination Deep Into a Pandemic Wave
otential Mechanisms for a ?Third Wave? and the Impact of Vaccination
* Bruce Y. Lee, MD, MBA Affiliations: Department of Medicine, University of Pittsburgh, School of Medicine, Biomedical Informatics, University of Pittsburgh, School of Medicine, Epidemiology, University of Pittsburgh, Graduate School of Public Health, Shawn T. Brown, PhD Affiliations: Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh Supercomputing Center, Carnegie Mellon University * , Philip Cooley, MS Affiliations: RTI International * , John J. Grefenstette, PhD Affiliations: Biostatistics, University of Pittsburgh, Graduate School of Public Health * , Richard K. Zimmerman, MD, MPH Affiliations: Family Medicine, University of Pittsburgh, School of Medicine * , Shanta M. Zimmer, MD Affiliations: Department of Medicine, University of Pittsburgh, School of Medicine * , Margaret A. Potter, JD, MS Affiliations: Health Policy and Management, University of Pittsburgh, Graduate School of Public Health * , Roni Rosenfeld, PhD Affiliations: School of Computer Science, Carnegie Mellon University * , William D. Wheaton, MA Affiliations: RTI International * , Ann E. Wiringa, MPH Affiliations: Department of Medicine, University of Pittsburgh, School of Medicine, Biomedical Informatics, University of Pittsburgh, School of Medicine, Epidemiology, University of Pittsburgh, Graduate School of Public Health * , Kristina M. Bacon, MPH Affiliations: Department of Medicine, University of Pittsburgh, School of Medicine, Biomedical Informatics, University of Pittsburgh, School of Medicine, Epidemiology, University of Pittsburgh, Graduate School of Public Health * , Donald S. Burke, MD Affiliations: Biomedical Informatics, University of Pittsburgh, School of Medicine, Epidemiology, University of Pittsburgh, Graduate School of Public Health
Abstract
Background
In December 2009, when the H1N1 influenza pandemic appeared to be subsiding, public health officials and unvaccinated individuals faced the question of whether continued H1N1 immunization was still worthwhile.
Purpose
To delineate what combinations of possible mechanisms could generate a third pandemic wave and then explore whether vaccinating the population at different rates and times would mitigate the wave.
Methods
As part of ongoing work with the Office of the Assistant Secretary for Preparedness and Response at the USDHHS during the H1N1 influenza pandemic, the University of Pittsburgh Models of Infectious Disease Agent Study team employed an agent-based computer simulation model of the Washington DC metropolitan region to delineate what mechanisms could generate a ?third pandemic wave? and explored whether vaccinating the population at different rates and times would mitigate the wave. This model included explicit representations of the region's individuals, school systems, workplaces/commutes, households, and communities.
Results
Three mechanisms were identified that could cause a third pandemic wave; substantially increased viral transmissibility from seasonal forcing (changing influenza transmission with changing environmental conditions, i.e., seasons) and progressive viral adaptation; an immune escape variant; and changes in social mixing from holiday school closures. Implementing vaccination for these mechanisms, even during the down-slope of the fall epidemic wave, significantly mitigated the third wave. Scenarios showed the gains from initiating vaccination earlier, increasing the speed of vaccination, and prioritizing population subgroups based on Advisory Committee on Immunization Practices recommendations.
Conclusions
Additional waves in an epidemic can be mitigated by vaccination even when an epidemic appears to be waning.
PII: S0749-3797(10)00443-5
doi:10.1016/j.amepre.2010.07.014
? 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
-
------<cite cite="http://www.ajpm-online.net/article/PIIS0749379710004435/abstract?rss=yes"></cite>
[Source: American Journal of Preventive Medicine, full text: <cite cite="http://www.ajpm-online.net/article/PIIS0749379710004435/abstract?rss=yes">Vaccination Deep Into a Pandemic Wave: Potential Mechanisms for a ?Third Wave? and the Impact of Vaccination</cite>. Abstract, edited.]
Vaccination Deep Into a Pandemic Wave
otential Mechanisms for a ?Third Wave? and the Impact of Vaccination * Bruce Y. Lee, MD, MBA Affiliations: Department of Medicine, University of Pittsburgh, School of Medicine, Biomedical Informatics, University of Pittsburgh, School of Medicine, Epidemiology, University of Pittsburgh, Graduate School of Public Health, Shawn T. Brown, PhD Affiliations: Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh Supercomputing Center, Carnegie Mellon University * , Philip Cooley, MS Affiliations: RTI International * , John J. Grefenstette, PhD Affiliations: Biostatistics, University of Pittsburgh, Graduate School of Public Health * , Richard K. Zimmerman, MD, MPH Affiliations: Family Medicine, University of Pittsburgh, School of Medicine * , Shanta M. Zimmer, MD Affiliations: Department of Medicine, University of Pittsburgh, School of Medicine * , Margaret A. Potter, JD, MS Affiliations: Health Policy and Management, University of Pittsburgh, Graduate School of Public Health * , Roni Rosenfeld, PhD Affiliations: School of Computer Science, Carnegie Mellon University * , William D. Wheaton, MA Affiliations: RTI International * , Ann E. Wiringa, MPH Affiliations: Department of Medicine, University of Pittsburgh, School of Medicine, Biomedical Informatics, University of Pittsburgh, School of Medicine, Epidemiology, University of Pittsburgh, Graduate School of Public Health * , Kristina M. Bacon, MPH Affiliations: Department of Medicine, University of Pittsburgh, School of Medicine, Biomedical Informatics, University of Pittsburgh, School of Medicine, Epidemiology, University of Pittsburgh, Graduate School of Public Health * , Donald S. Burke, MD Affiliations: Biomedical Informatics, University of Pittsburgh, School of Medicine, Epidemiology, University of Pittsburgh, Graduate School of Public Health
Abstract
Background
In December 2009, when the H1N1 influenza pandemic appeared to be subsiding, public health officials and unvaccinated individuals faced the question of whether continued H1N1 immunization was still worthwhile.
Purpose
To delineate what combinations of possible mechanisms could generate a third pandemic wave and then explore whether vaccinating the population at different rates and times would mitigate the wave.
Methods
As part of ongoing work with the Office of the Assistant Secretary for Preparedness and Response at the USDHHS during the H1N1 influenza pandemic, the University of Pittsburgh Models of Infectious Disease Agent Study team employed an agent-based computer simulation model of the Washington DC metropolitan region to delineate what mechanisms could generate a ?third pandemic wave? and explored whether vaccinating the population at different rates and times would mitigate the wave. This model included explicit representations of the region's individuals, school systems, workplaces/commutes, households, and communities.
Results
Three mechanisms were identified that could cause a third pandemic wave; substantially increased viral transmissibility from seasonal forcing (changing influenza transmission with changing environmental conditions, i.e., seasons) and progressive viral adaptation; an immune escape variant; and changes in social mixing from holiday school closures. Implementing vaccination for these mechanisms, even during the down-slope of the fall epidemic wave, significantly mitigated the third wave. Scenarios showed the gains from initiating vaccination earlier, increasing the speed of vaccination, and prioritizing population subgroups based on Advisory Committee on Immunization Practices recommendations.
Conclusions
Additional waves in an epidemic can be mitigated by vaccination even when an epidemic appears to be waning.
PII: S0749-3797(10)00443-5
doi:10.1016/j.amepre.2010.07.014
? 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
-
------<cite cite="http://www.ajpm-online.net/article/PIIS0749379710004435/abstract?rss=yes"></cite>