Strategies for Early Vaccination During Novel Influenza Outbreaks

Ongoing research and technology developments hold the promise of rapid production and large-scale deployment of strain-specific or cross-protective vaccines for novel influenza viruses. We sought to investigate the impact of early vaccination on age-specific attack rates and evaluate the outcomes of different vaccination strategies that are influenced by the level of single or two-dose vaccine-induced protections. We developed and parameterized an agent-based model for two population demographics of urban and remote areas in Canada. Our results demonstrate that there is a time period before and after the onset of epidemic, during which the outcomes of vaccination strategies may differ significantly and are highly influenced by demographic characteristics. For the urban population, attack rates were lowest for children younger than 5 years of age in all vaccination strategies. However, for the remote population, the lowest attack rates were obtained for adults older than 50 years of age in most strategies. We found that the reduction of attack rates following the start of vaccination campaigns during the epidemic depends critically on the disease transmissibility, suggesting that for a sufficiently high transmissibility, vaccine delivery after the onset of epidemic has little or no effect, regardless of the population demographics.

[1]  L. Vézina,et al.  The production of hemagglutinin-based virus-like particles in plants: a rapid, efficient and safe response to pandemic influenza. , 2010, Plant biotechnology journal.

[2]  Julia E. Aledort,et al.  Non-pharmaceutical public health interventions for pandemic influenza: an evaluation of the evidence base , 2007, BMC public health.

[3]  S. Moghadas,et al.  The impact of ethnicity and geographical location of residence on the 2009 influenza H1N1 pandemic vaccination , 2014, Epidemiology and Infection.

[4]  A. Nizam,et al.  Containing pandemic influenza with antiviral agents. , 2004, American journal of epidemiology.

[5]  Peter Gates,et al.  Effects of backpacking holidays in Australia on alcohol, tobacco and drug use of UK residents , 2007, BMC public health.

[6]  D. Fedson.  Pandemic influenza and the global vaccine supply. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[7]  V Demicheli,et al.  Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review , 2005, The Lancet.

[8]  V Demicheli,et al.  Assessment of the efficacy and effectiveness of influenza vaccines in healthy children: systematic review , 2005, The Lancet.

[9]  R. Brookmeyer,et al.  Incubation periods of acute respiratory viral infections: a systematic review , 2009, The Lancet Infectious Diseases.

[10]  D. Cummings,et al.  Strategies for containing an emerging influenza pandemic in Southeast Asia , 2005, Nature.

[11]  K. Nichol,et al.  The efficacy, effectiveness and cost-effectiveness of inactivated influenza virus vaccines. , 2003, Vaccine.

[12]  J. Treanor,et al.  Protective efficacy of a trivalent recombinant hemagglutinin protein vaccine (FluBlok®) against influenza in healthy adults: a randomized, placebo-controlled trial. , 2011, Vaccine.

[13]  Yu Wang,et al.  Safety and immunogenicity of an inactivated adjuvanted whole-virion influenza A (H5N1) vaccine: a phase I randomised controlled trial , 2006, The Lancet.

[14]  Bjoern Peters,et al.  Pre-existing immunity against swine-origin H1N1 influenza viruses in the general human population , 2009, Proceedings of the National Academy of Sciences.

[15]  J. Shiver,et al.  Preclinical efficacy of a prototype DNA vaccine: Enhanced protection against antigenic drift in influenza virus , 1995, Nature Medicine.

[16]  D. Skowronski,et al.  Low 2012–13 Influenza Vaccine Effectiveness Associated with Mutation in the Egg-Adapted H3N2 Vaccine Strain Not Antigenic Drift in Circulating Viruses , 2014, PloS one.

[17]  Luiz C. Mostaço-Guidolin,et al.  Transmissibility of the 2009 H1N1 pandemic in remote and isolated Canadian communities: a modelling study , 2012, BMJ Open.

[18]  B. Yassine-Diab,et al.  Influenza virus-like particle vaccines made in Nicotiana benthamiana elicit durable, poly-functional and cross-reactive T cell responses to influenza HA antigens. , 2014, Clinical immunology.

[19]  M. Halloran,et al.  Antiviral effects on influenza viral transmission and pathogenicity: observations from household-based trials. , 2006, American journal of epidemiology.

[20]  D. Vaughn,et al.  Rapid Immunization Against H5N1: A Randomized Trial Evaluating Homologous and Cross-Reactive Immune Responses to AS03A-Adjuvanted Vaccination in Adults , 2011, The Journal of infectious diseases.

[21]  G. Glenn,et al.  A recombinant viruslike particle influenza A (H7N9) vaccine. , 2013, The New England journal of medicine.

[22]  R. Webby,et al.  Traditional and New Influenza Vaccines , 2013, Clinical Microbiology Reviews.

[23]  Kathryn T. Morrison,et al.  The impact of geographical location of residence on disease outcomes among Canadian First Nations populations during the 2009 influenza A(H1N1) pandemic. , 2014, Health & place.

[24]  V Demicheli,et al.  Antivirals for influenza in healthy adults: systematic review , 2006, The Lancet.

[25]  Gergely Röst,et al.  Post-exposure prophylaxis during pandemic outbreaks , 2009, BMC medicine.

[26]  V. Duvvuri,et al.  Highly conserved cross-reactive CD4+ T-cell HA-epitopes of seasonal and the 2009 pandemic influenza viruses. , 2010, Influenza and other respiratory viruses.

[27]  Luiz C. Mostaço-Guidolin,et al.  The Impact of Demographic Variables on Disease Spread: Influenza in Remote Communities , 2011 .

[28]  Luiz C. Mostaço-Guidolin,et al.  Variability in transmissibility of the 2009 H1N1 pandemic in Canadian communities , 2011, BMC Research Notes.

[29]  M. Laskowski,et al.  Antiviral Strategies for Emerging Influenza Viruses in Remote Communities , 2014, PloS one.

[30]  Aleksander B. Demko,et al.  A Software Development Framework for Agent-Based Infectious Disease Modelling , 2011 .

[31]  M. Zambon,et al.  Confronting the avian influenza threat: vaccine development for a potential pandemic , 2004, The Lancet Infectious Diseases.

[32]  Qi Chen,et al.  Vaccine development for protecting swine against influenza virus , 2012, Animal Health Research Reviews.

[33]  David Buckeridge,et al.  Estimated epidemiologic parameters and morbidity associated with pandemic H1N1 influenza , 2010, Canadian Medical Association Journal.

[34]  H. Oshitani,et al.  Potential benefits and limitations of various strategies to mitigate the impact of an influenza pandemic , 2006, Journal of Infection and Chemotherapy.

[35]  K. Nichol,et al.  Effectiveness of influenza vaccine in the community-dwelling elderly. , 2007, The New England journal of medicine.

[36]  Phillip D. Stroud,et al.  Pandemic simulation of antivirals + school closures: buying time until strain-specific vaccine is available , 2008, Comput. Math. Organ. Theory.

[37]  N. Cox,et al.  Effectiveness of influenza vaccination of day care children in reducing influenza-related morbidity among household contacts. , 2000, JAMA.

[38]  Trang Vu,et al.  A meta-analysis of effectiveness of influenza vaccine in persons aged 65 years and over living in the community. , 2002, Vaccine.