Science
25 September 2009  Vol 325, Issue 5948, Pages 1585-1740
http://www.sciencemag.org/current.dtl

Reports
Optimizing Influenza Vaccine Distribution
Jan Medlock1,2,* and Alison P. Galvani1

The criteria to assess public health policies are fundamental to policy optimization. Using a model parametrized with survey-based contact data and mortality data from influenza pandemics, we determined optimal vaccine allocation for five outcome measures: deaths, infections, years of life lost, contingent valuation, and economic costs. We find that optimal vaccination is achieved by prioritization of schoolchildren and adults aged 30 to 39 years. Schoolchildren are most responsible for transmission, and their parents serve as bridges to the rest of the population. Our results indicate that consideration of age-specific transmission dynamics is paramount to the optimal allocation of influenza vaccines. We also found that previous and new recommendations from the U.S. Centers for Disease Control and Prevention both for the novel swine-origin influenza and, particularly, for seasonal influenza, are suboptimal for all outcome measures.

1 Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, New Haven, CT 06520–8034, USA.
2 Department of Mathematical Sciences, Clemson University, Box 340975, Clemson, SC 29634–0975, USA.