Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health
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Strategy for Distribution of Influenza Vaccine to High-Risk Groups and Children
From the Department of Biostatistics, The Rollins School of Public Health, Emory University, Atlanta, GA.
Despite evidence that vaccinating schoolchildren against influenza is effective in limiting community-level transmission, the United States has had a long-standing government strategy of recommending that vaccine be concentrated primarily in high-risk groups and distributed to those people who keep the health system and social infrastructure operating. Because of this years influenza vaccine shortage, a plan was enacted to distribute the limited vaccine stock to these groups first. This vaccination strategy, based on direct protection of those most at risk, has not been very effective in reducing influenza morbidity and mortality. Although it is too late to make changes this year, the current influenza vaccine crisis affords the opportunity to examine an alternative for future years. The alternative plan, supported by mathematical models and influenza field studies, would be to concentrate vaccine in schoolchildren, the population group most responsible for transmission, while also covering the reachable high-risk groups, who would also receive considerable indirect protection. In conjunction with a plan to ensure an adequate vaccine supply, this alternative influenza vaccination strategy would help control interpandemic influenza and be instrumental in preparing for pandemic influenza. The effectiveness of the alternative plan could be assessed through nationwide community studies.
antiviral agents; immunity, herd; influenza; influenza A virus; influenza vaccines; mass immunization
Reprint requests to Dr. Ira M. Longini, Jr., Department of Biostatistics, The Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322 (e-mail: longini{at}sph.emory.edu).
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