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Measles outbreak response decision-making under uncertainty: a retrospective analysis
Christopher J Fonnesbeck1, Katriona Shea2,3, Spencer Carran3
1Department of Biostatistics, Vanderbilt University Medical Center, Eleventh Floor, Suite 11000, 2525 West End Avenue, Nashville, TN, USA fonnesbeck@gmail.com.
Journal of the Royal Society, Interface
|March 23, 2018
Summary
Reactive vaccination campaigns face uncertainty. This study integrates real-time data and modeling to identify optimal targets, revealing that adult vaccination is crucial for controlling resurgent measles outbreaks.
Area of Science:
- Epidemiology
- Mathematical Modeling
- Public Health
Background:
- Resurgent outbreaks of vaccine-preventable diseases pose a significant public health challenge.
- Reactive vaccination campaigns are vital for outbreak control but face uncertainty regarding optimal targets.
- Real-time surveillance is critical but can be limited by disease confirmation specificity.
Purpose of the Study:
- To develop and apply an integrated modeling framework for optimizing reactive vaccination strategies.
- To evaluate the impact of age-specific susceptibility and confirmation rates on outbreak control.
- To assess the effectiveness of age-targeted interventions during resurgent disease outbreaks.
Main Methods:
- Synthesized historical demographic and vaccination data with real-time outbreak surveillance.
- Employed a dynamic transmission model and an age-specific disease confirmation model.
- Applied the framework to the 1996-1997 measles outbreak in São Paulo, Brazil, using truncated surveillance data.
Main Results:
- An excess of susceptible adults was identified as a key factor hindering child-targeted campaigns.
- Failing to account for age-specific confirmation rates led to an underestimation of adult vaccination importance.
- The integrated model provided insights into optimal vaccination targets under data limitations.
Conclusions:
- Integrated modeling enhances decision-making for reactive vaccination campaigns.
- Age-specific factors, including adult susceptibility and confirmation rates, are critical for effective outbreak control.
- Targeting vaccination efforts based on age-specific data is essential for managing resurgent vaccine-preventable diseases.
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