DIMACS Working Group on Methodologies for Comparing Vaccination Strategies
May 17 - 20, 2004
DIMACS Center, CoRE Building, Rutgers University
Presented under the auspices of the Special Focus on
Computational and Mathematical Epidemiology.
- John Glasser, CDC, firstname.lastname@example.org
- Herbert Hethcote, University of Iowa, email@example.com
Link to the DIMACS Workshop on Evolutionary Considerations in Vaccine Use, June 27 - 30, 2005.
This working group will focus on the use of mathematical modeling and
computer simulations to provide theoretical comparisons of vaccination
and other intervention programs. Examples of the effective use of
modeling will be studied for vaccine-preventable diseases such as
measles, rubella, varicella, pertussis, polio, Haemophilus influenza
type b and pneumococcal, Hepatitis A and B, and Lyme disease. (See,
[Garnett and Waddell (2000),
Grenfell and Bolker (1998),
Rohani, Earn and Grenfell (2000),
Schuette and Hethcote (1999)].) When vaccination strategies compare
vaccination of different age groups, age-structured mathematical
models are necessary. Computer simulations of these highly complex
systems with hundreds of demographic and epidemiological classes allow
comparisons of vaccination strategies and rapid evaluation of
potential intervention programs when field trials would be
prohibitively expensive. Both expected and worst case scenarios must
be considered. We will bring working epidemiologists and policymakers
together with experts in mathematical modeling and computer simulation
in order to formulate and analyze models to deal with current problems
and explore ways to simulate larger, more complex, more realistic
models. It is likely that a subgroup of this working group will
emphasize influenza. The persistence of influenza depends on its
ability to evolve
[Andreasen, Lin and Levin (1997),
Gupta, Ferguson and Anderson (1998),
Lin, Andreasen and Levin (1999)] so that new strains and subtypes of the
virus appear and old ones reappear. This constant evolution means that
vaccines need to be updated frequently and that resistance to drug
therapies can easily arise. These issues make modeling difficult and
require large, powerful computational methods to analyze the
models. Some specific research issues to which the group will apply
its methods are the following. How will varicella vaccination affect
the incidence of shingles? Is acellular pertussis vaccinatiion of
adolescents or adults more effective in reducing cases among infants
than vaccination of children? Because the oral polio vaccine virus can
mutate back to the wild virus, as occurred recently in the Caribbean
and the Philippines, can polio be eradicated using the oral polio
vaccine alone? How does the yearly composition of the influenza
vaccine affect the drift of the influenza virus? We expect that this
working group will spawn a separate group to develop and analyze
models for vaccination strategies in the event of or in anticipation
of bioterrorist attacks involving smallpox, anthrax, or
influenza. Research issues here include: what are the risks/advantages
of different smallpox vaccination strategies using existing supplies
of the vaccine? How do the conclusions change if we dilute existing
supplies so as to allow more people to be vaccinated but can only
achieve a certain probability of protection or only a reduction of
symptoms to treatable levels? How do vaccination strategies depend
upon our ability to identify a spot smallpox epidemic? How do these
conclusions change for diseases such as anthrax where transmission is
not person-to-person? Recent work on smallpox and anthrax (e.g.,
[Kaufman, Meltzer and Schmid (1997),
Meltzer, Damon, LeDuc and Millar (2001)]) will provide background for this work.
Andreasen, V., Lin, J., and Levin, S.A. (1997),
"The dynamics of cocirculating influenza strains conferring partial cross-immunity,"
J. Math. Biol., 35, 825-842.
Garnett, G.P., and Waddell, H.C. (2000),
"Public health paradoxes and the epidemiological impact of an HPV vaccine,"
J. Clin. Virol., 19, 101-111.
Grenfell, B.T., and Bolker, B.M. (1998),
"Cities and villages: Infection hierarchies in a measles metapopulation,"
Ecol. Let., 1, 63-70.
Gupta, S., Ferguson, N., and Anderson, R. (1998),
"Chaos, persistence, and evolution of strain structure in antigenically diverse infectious agents,"
Science, 280, 912-915.
Hethcote, H.W. (1999),
"Simulations of pertussis epidemiology in the United States: Effects of adult booster doses,"
Math. Biosci., 158, 47-73.
Kaufman, A.F., Meltzer, M.I., and Schmid, G.P. (1997),
"The economic impact of a bioterrorist attack: Are prevention and postattack intervention programs justificable?"
Emerging Infectious Diseases, 3,
Lin, J., Andreasen, V., and Levin, S.A. (1999),
"Dynamics of influenza A drift: the linear three-strain model,"
Math Biosci, 162, 33-51.
Meltzer, M.I., Damon, I., LeDuc, J.W., and Millar, J.D. (2001),
"Modeling potential responses to smallpox as a bioterrorist weapon,"
Emerging Infectious Diseases, 7,
Rohani, P., Earn, D.J.D., and Grenfell, B.T. (2000),
"Impact of immunisation on pertussis transmission in England and Wales,"
LANCET, 355, 285-286.
Schuette, M.C. and Hethcote, W.H. (1999),
"Modeling the effects of varicella vaccination programs on the incidence of chickenpox and shingles,"
Bull. Math. Biol., 61, 1031-1064.
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Document last modified on March 10, 2004.