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Optimizing Reactive Responses to Outbreaks of Immunizing Infections: Balancing Case Management and Vaccination

For vaccine-preventable infections, immunization generally needs to be supplemented by palliative care of individuals missed by the vaccination. Costs and availability of vaccine doses and palliative care vary by disease and by region. In many situations, resources for delivery of palliative care ar...

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Autores principales: Klepac, Petra, Bjørnstad, Ottar N., Metcalf, C. Jessica E., Grenfell, Bryan T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3416818/
https://www.ncbi.nlm.nih.gov/pubmed/22899996
http://dx.doi.org/10.1371/journal.pone.0041428
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author Klepac, Petra
Bjørnstad, Ottar N.
Metcalf, C. Jessica E.
Grenfell, Bryan T.
author_facet Klepac, Petra
Bjørnstad, Ottar N.
Metcalf, C. Jessica E.
Grenfell, Bryan T.
author_sort Klepac, Petra
collection PubMed
description For vaccine-preventable infections, immunization generally needs to be supplemented by palliative care of individuals missed by the vaccination. Costs and availability of vaccine doses and palliative care vary by disease and by region. In many situations, resources for delivery of palliative care are independent of resources required for vaccination; however we also need to consider the conservative scenario where there is some trade-off between efforts, which is of potential relevance for resource-poor settings. We formulate an SEIR model that includes those two control strategies – vaccination and palliative care. We consider their relative merit and optimal allocation in the context of a highly efficacious vaccine, and under the assumption that palliative care may reduce transmission. We investigate the utility of a range of mixed or pure strategies that can be implemented after an epidemic has started, and look for rule-of-thumb principles of how best to reduce the burden of disease during an acute outbreak over a spectrum of vaccine-preventable infections. Intuitively, we expect the best strategy to initially focus on vaccination, and enhanced palliative care after the infection has peaked, but a number of plausible realistic constraints for control result in important qualifications on the intervention strategy. The time in the epidemic when one should switch strategy depends sensitively on the relative cost of vaccine to palliative care, the available budget, and [Image: see text]. Crucially, outbreak response vaccination may be more effective in managing low-[Image: see text] diseases, while high [Image: see text] scenarios enhance the importance of routine vaccination and case management.
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spelling pubmed-34168182012-08-16 Optimizing Reactive Responses to Outbreaks of Immunizing Infections: Balancing Case Management and Vaccination Klepac, Petra Bjørnstad, Ottar N. Metcalf, C. Jessica E. Grenfell, Bryan T. PLoS One Research Article For vaccine-preventable infections, immunization generally needs to be supplemented by palliative care of individuals missed by the vaccination. Costs and availability of vaccine doses and palliative care vary by disease and by region. In many situations, resources for delivery of palliative care are independent of resources required for vaccination; however we also need to consider the conservative scenario where there is some trade-off between efforts, which is of potential relevance for resource-poor settings. We formulate an SEIR model that includes those two control strategies – vaccination and palliative care. We consider their relative merit and optimal allocation in the context of a highly efficacious vaccine, and under the assumption that palliative care may reduce transmission. We investigate the utility of a range of mixed or pure strategies that can be implemented after an epidemic has started, and look for rule-of-thumb principles of how best to reduce the burden of disease during an acute outbreak over a spectrum of vaccine-preventable infections. Intuitively, we expect the best strategy to initially focus on vaccination, and enhanced palliative care after the infection has peaked, but a number of plausible realistic constraints for control result in important qualifications on the intervention strategy. The time in the epidemic when one should switch strategy depends sensitively on the relative cost of vaccine to palliative care, the available budget, and [Image: see text]. Crucially, outbreak response vaccination may be more effective in managing low-[Image: see text] diseases, while high [Image: see text] scenarios enhance the importance of routine vaccination and case management. Public Library of Science 2012-08-10 /pmc/articles/PMC3416818/ /pubmed/22899996 http://dx.doi.org/10.1371/journal.pone.0041428 Text en © 2012 Klepac et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Klepac, Petra
Bjørnstad, Ottar N.
Metcalf, C. Jessica E.
Grenfell, Bryan T.
Optimizing Reactive Responses to Outbreaks of Immunizing Infections: Balancing Case Management and Vaccination
title Optimizing Reactive Responses to Outbreaks of Immunizing Infections: Balancing Case Management and Vaccination
title_full Optimizing Reactive Responses to Outbreaks of Immunizing Infections: Balancing Case Management and Vaccination
title_fullStr Optimizing Reactive Responses to Outbreaks of Immunizing Infections: Balancing Case Management and Vaccination
title_full_unstemmed Optimizing Reactive Responses to Outbreaks of Immunizing Infections: Balancing Case Management and Vaccination
title_short Optimizing Reactive Responses to Outbreaks of Immunizing Infections: Balancing Case Management and Vaccination
title_sort optimizing reactive responses to outbreaks of immunizing infections: balancing case management and vaccination
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3416818/
https://www.ncbi.nlm.nih.gov/pubmed/22899996
http://dx.doi.org/10.1371/journal.pone.0041428
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