Prospects for pandemic influenza control with currently available vaccines and antivirals

Since an influenza virus variant of pandemic potential may appear at any time, plans must be made to use currently available vaccines and antivirals most advantageously. Inactivated vaccines remain the principal intervention for the near future, and it can be assumed that quantities available at critical points in the epidemic will be limited unless advances are made in methods of vaccine production. Repeated demonstration of the effectiveness of vaccination of older persons in preventing hospitalization and death confirms that the traditional high-risk groups should be given priority. Since community transmission can be interrupted by vaccinating school-age children, this group may also be targeted. Antivirals in use and under development will almost certainly be active against the pandemic variant. Use during pandemics should be extensive but may be limited by the quantity of drugs available, the logistics of storage and distribution, and the possibility of side effects.