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Los Alamos model shows even poorly matched vaccine best control

Model from Los Alamos suggest vaccinating children, even with poorly matched vaccine.

http://news.yahoo.com/s/nm/20060403...QKTvyIi;_ylu=X3oDMTBiMW04NW9mBHNlYwMlJVRPUCUl


Travel restrictions and school closures will do little to stop a pandemic of bird flu from marching across the United States, but they may slow it enough to distribute drugs and vaccines, according to a new study published on Monday.
"It's probably not going to be practical to contain a potential pandemic by merely trying to limit contact between people such as by travel restrictions, quarantine or even closing schools," said Timothy Germann of Los Alamos National Laboratory in New Mexico, who worked on the report.

"But we find that these measures are useful in buying time to produce and distribute sufficient quantities of vaccine and antiviral drugs."
Their study, published in the Proceedings of the National Academy of Sciences, supports the approach being pursued by the U.S. government and recommended by the World Health Organization for preparing for a possible influenza pandemic.

"Our model suggests that the rapid production and distribution of vaccines, even if poorly matched to circulating strains, could significantly slow disease spread and limit the number ill to less than 10 percent of the population, particularly if children are preferentially vaccinated," the team at the U.S. Department of Energy's Los Alamos National Laboratory and the University of Washington wrote.

Catherine Macken of Los Alamos said the computer model used in the study provided a surprising finding -- using a weak vaccine in many people would be better than trying to vaccinate a smaller number of people with a more effective dose.

"If you reduce somewhat the length of time that someone is infective ... you end up getting a significant impact," Macken said in a telephone interview.

"You might be better off vaccinating twice as many people, getting a lower level of protection, but still getting an improvement in susceptibility."

No flu vaccine is perfect and experts have been uncertain which approach would work better.The team at Los Alamos and the University of Washington ran a complex computer simulation of what the spread of bird flu might look like in the United States. They say their findings would hold for any highly mobile society.

"In the event that a pandemic influenza virus does reach the U.S., according to our results, the U.S. population could begin to experience a nation-wide pandemic within 1 month of the earliest introductions," the researchers wrote.

The model assumes that about a third of the population would become infected -- the rate seen in the past two pandemics, in 1957 and 1968.

They included several circumstances for people to meet and potentially pass the virus along, including households, neighborhoods, preschools, playgroups, schools, shops and work.
 
Stockpile vaccines

Stockpile vaccines

Modeling shows that vaccines should be stockpiled before the pandemic strain starts.

http://www.newscientist.com/article/dn8943-stockpile-human-bird-flu-vaccine-now-say-experts.html
22:00 03 April 2006
NewScientist.com news service
Debora MacKenzie


Countries should stockpile vaccines against H5N1 flu even before any H5N1 pandemic begins, experts warn. A new modelling study shows that without such vaccines, and antiviral drugs, efforts such as school closures and travel restrictions will have almost no effect on the number of deaths a pandemic would cause in the US.

Yet that is what the country currently relies on. In March, US Health Secretary Michael Leavitt told a Congressional panel that "in the first six months of a pandemic we are dependent on basic public health and social distancing?. The term "social distancing" refers to measures that reduce human contact, such as school and business closures.

It would take drug companies six months from the start of a pandemic to produce an effective vaccine, he said. This is because they must wait until the pandemic actually starts before designing a vaccine that matches the virus.

But before then vaccines can be made to match currently circulating H5N1 viruses. Vaccinated people might not be completely immune to a subsequent H5N1 pandemic, but they might get less seriously ill, and pass on less virus.
The US plans to spend $1.2 billion on pre-pandemic vaccine (see "US launches plan to battle flu pandemic"), and last week the UK announced it would buy two million doses. But no country plans to stockpile enough for half of their population.

"It would be a very good idea to stockpile vaccine now," says Ira Longini of the University of Washington at Seattle, US. "Our studies show that without a lot of antiviral drugs or vaccine ? or both ? you don?t get anywhere," he told New Scientist. Antiviral drug production is now at capacity, but H5 vaccine production is minimal.

Longini and colleagues simulated the early days of a flu pandemic in the US using a new kind of supercomputer model designed to predict the rate of spread very early in an epidemic. "The effectiveness of a low-efficacy vaccine was somewhat surprising" in protecting the population, Timothy Germann, the paper?s lead author, told New Scientist.
They modelled the effects of giving half the US population one shot of a vaccine that cut susceptibility to flu by only one-third, and transmission of the virus by half. They also modelled school closure and other social distancing, and treating every sick person and their close contacts with antiviral drugs.

For a poorly contagious virus, school closure, antiviral drugs, or vaccination on their own limited cases to only a few per thousand. But for a moderately contagious virus, similar to the 1918 pandemic, far more antiviral drug than the 20 million treatments the US plans to stockpile were needed, unless vaccine or social distancing was applied as well.

For a moderately contagious virus, social distancing alone was the same as no intervention at all ? nearly half of the population fell ill. But social distancing plus drugs or vaccine limited cases to only a few per thousand. With all three there were fewer still.

Antiviral drugs plus school closure, but no vaccine, worked, though not as well as with the vaccine for more highly contagious viruses. And Longini notes it would be unwise to rely on drugs, in case the virus becomes drug resistant.

Journal reference: Proceedings of the National Academy of Sciences (DOI: 10.1073/pnas.0601266103)
 
Re: Los Alamos model shows even poorly matched vaccine best control

These are also posted under Clinical Medicine - Vaccine reviews. Not sure what discussion is there.

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Re: Los Alamos model shows even poorly matched vaccine best control

AlaskaDenise- Sorry to repeat your post. Sometimes the line is blurry between subject forums. I saw that this forum had the modeling and government planning on it.:o
 
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