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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Prioritization of Influenza Pandemic Vaccination to Minimize Years of Life Lost</title>
<author><name sortKey="Miller, Mark A" sort="Miller, Mark A" uniqKey="Miller M" first="Mark A." last="Miller">Mark A. Miller</name>
<affiliation><nlm:aff id="A1">Fogarty International Center, National Institutes of Health, Bethesda, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Viboud, Cecile" sort="Viboud, Cecile" uniqKey="Viboud C" first="Cecile" last="Viboud">Cecile Viboud</name>
<affiliation><nlm:aff id="A1">Fogarty International Center, National Institutes of Health, Bethesda, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Olson, Donald R" sort="Olson, Donald R" uniqKey="Olson D" first="Donald R." last="Olson">Donald R. Olson</name>
<affiliation><nlm:aff id="A2">New York City Department of Health and Mental Hygiene, New York, New York</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Grais, Rebecca F" sort="Grais, Rebecca F" uniqKey="Grais R" first="Rebecca F." last="Grais">Rebecca F. Grais</name>
<affiliation><nlm:aff id="A1">Fogarty International Center, National Institutes of Health, Bethesda, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rabaa, Maia A" sort="Rabaa, Maia A" uniqKey="Rabaa M" first="Maia A." last="Rabaa">Maia A. Rabaa</name>
<affiliation><nlm:aff id="A1">Fogarty International Center, National Institutes of Health, Bethesda, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Simonsen, Lone" sort="Simonsen, Lone" uniqKey="Simonsen L" first="Lone" last="Simonsen">Lone Simonsen</name>
<affiliation><nlm:aff id="A3">Department of Global Health, School of Public Health and Health Services, George Washington University, Washington, DC</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">18558871</idno>
<idno type="pmc">3206321</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206321</idno>
<idno type="RBID">PMC:3206321</idno>
<idno type="doi">10.1086/589716</idno>
<date when="2008">2008</date>
<idno type="wicri:Area/Pmc/Corpus">000573</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000573</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Prioritization of Influenza Pandemic Vaccination to Minimize Years of Life Lost</title>
<author><name sortKey="Miller, Mark A" sort="Miller, Mark A" uniqKey="Miller M" first="Mark A." last="Miller">Mark A. Miller</name>
<affiliation><nlm:aff id="A1">Fogarty International Center, National Institutes of Health, Bethesda, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Viboud, Cecile" sort="Viboud, Cecile" uniqKey="Viboud C" first="Cecile" last="Viboud">Cecile Viboud</name>
<affiliation><nlm:aff id="A1">Fogarty International Center, National Institutes of Health, Bethesda, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Olson, Donald R" sort="Olson, Donald R" uniqKey="Olson D" first="Donald R." last="Olson">Donald R. Olson</name>
<affiliation><nlm:aff id="A2">New York City Department of Health and Mental Hygiene, New York, New York</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Grais, Rebecca F" sort="Grais, Rebecca F" uniqKey="Grais R" first="Rebecca F." last="Grais">Rebecca F. Grais</name>
<affiliation><nlm:aff id="A1">Fogarty International Center, National Institutes of Health, Bethesda, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rabaa, Maia A" sort="Rabaa, Maia A" uniqKey="Rabaa M" first="Maia A." last="Rabaa">Maia A. Rabaa</name>
<affiliation><nlm:aff id="A1">Fogarty International Center, National Institutes of Health, Bethesda, Maryland</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Simonsen, Lone" sort="Simonsen, Lone" uniqKey="Simonsen L" first="Lone" last="Simonsen">Lone Simonsen</name>
<affiliation><nlm:aff id="A3">Department of Global Health, School of Public Health and Health Services, George Washington University, Washington, DC</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">The Journal of infectious diseases</title>
<idno type="ISSN">0022-1899</idno>
<idno type="eISSN">1537-6613</idno>
<imprint><date when="2008">2008</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">How to allocate limited vaccine supplies in the event of an influenza pandemic is currently under debate. Conventional vaccination strategies focus on those at highest risk for severe outcomes, including seniors, but do not consider (1) the signature pandemic pattern in which mortality risk is shifted to younger ages, (2) likely reduced vaccine response in seniors, and (3) differences in remaining years of life with age.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">We integrated these factors to project the age-specific years of life lost (YLL) and saved in a future pandemic, on the basis of mortality patterns from 3 historical pandemics, age-specific vaccine efficacy, and the 2000 US population structure.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">For a 1918-like scenario, the absolute mortality risk is highest in people <45 years old; in contrast, seniors (those ⩾65 years old) have the highest mortality risk in the 1957 and 1968 scenarios. The greatest YLL savings would be achieved by targeting different age groups in each scenario; people <45 years old in the 1918 scenario, people 45–64 years old in the 1968 scenario, and people >45 years old in the 1957 scenario.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Our findings shift the focus of pandemic vaccination strategies onto younger populations and illustrate the need for real-time surveillance of mortality patterns in a future pandemic. Flexible setting of vaccination priority is essential to minimize mortality.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article" xml:lang="en"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0413675</journal-id>
<journal-id journal-id-type="pubmed-jr-id">4830</journal-id>
<journal-id journal-id-type="nlm-ta">J Infect Dis</journal-id>
<journal-title-group><journal-title>The Journal of infectious diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">0022-1899</issn>
<issn pub-type="epub">1537-6613</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">18558871</article-id>
<article-id pub-id-type="pmc">3206321</article-id>
<article-id pub-id-type="doi">10.1086/589716</article-id>
<article-id pub-id-type="manuscript">NIHMS96632</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Prioritization of Influenza Pandemic Vaccination to Minimize Years of Life Lost</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Miller</surname>
<given-names>Mark A.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Viboud</surname>
<given-names>Cecile</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Olson</surname>
<given-names>Donald R.</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Grais</surname>
<given-names>Rebecca F.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rabaa</surname>
<given-names>Maia A.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Simonsen</surname>
<given-names>Lone</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Fogarty International Center, National Institutes of Health, Bethesda, Maryland</aff>
<aff id="A2"><label>2</label>
New York City Department of Health and Mental Hygiene, New York, New York</aff>
<aff id="A3"><label>3</label>
Department of Global Health, School of Public Health and Health Services, George Washington University, Washington, DC</aff>
<author-notes><corresp id="cor1">Reprints or correspondence: Dr. Mark Miller, Div. of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, 16 Center Dr., Bethesda, MD 20892 (<email>millemar@mail.nih.gov</email>
)</corresp>
<fn id="FN1" fn-type="conflict"><p id="P26">Potential conflicts of interest: none reported.</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>20</day>
<month>2</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub"><day>1</day>
<month>8</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>2</day>
<month>11</month>
<year>2011</year>
</pub-date>
<volume>198</volume>
<issue>3</issue>
<fpage>305</fpage>
<lpage>311</lpage>
<permissions><copyright-statement>© 2008 by the Infectious Diseases Society of America. All rights reserved.</copyright-statement>
<copyright-year>2008</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">How to allocate limited vaccine supplies in the event of an influenza pandemic is currently under debate. Conventional vaccination strategies focus on those at highest risk for severe outcomes, including seniors, but do not consider (1) the signature pandemic pattern in which mortality risk is shifted to younger ages, (2) likely reduced vaccine response in seniors, and (3) differences in remaining years of life with age.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">We integrated these factors to project the age-specific years of life lost (YLL) and saved in a future pandemic, on the basis of mortality patterns from 3 historical pandemics, age-specific vaccine efficacy, and the 2000 US population structure.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">For a 1918-like scenario, the absolute mortality risk is highest in people <45 years old; in contrast, seniors (those ⩾65 years old) have the highest mortality risk in the 1957 and 1968 scenarios. The greatest YLL savings would be achieved by targeting different age groups in each scenario; people <45 years old in the 1918 scenario, people 45–64 years old in the 1968 scenario, and people >45 years old in the 1957 scenario.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Our findings shift the focus of pandemic vaccination strategies onto younger populations and illustrate the need for real-time surveillance of mortality patterns in a future pandemic. Flexible setting of vaccination priority is essential to minimize mortality.</p>
</sec>
</abstract>
<funding-group><award-group><funding-source country="United States">Fogarty International Center : FIC</funding-source>
<award-id>Z99 TW999999 || TW</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>
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