Mitigation strategies for pandemic influenza in the United States

Footnotes

• ^†To whom correspondence should be addressed. E-mail: tcg{at}lanl.gov

• Author contributions: T.C.G., K.K., I.M.L., and C.A.M. designed research, performed research, contributed new reagents/analytic tools, analyzed data, and wrote the paper.

• ↵ § In fact, efficacy of experimental vaccines against a novel pandemic strain cannot be ascertained in the absence of actual viral challenge; immunogenicity alone can be determined. Experimental vaccines based on avian influenza virus have required much greater amounts of antigen for acceptable levels of immunogenicity than standard human vaccines. This discrepancy does not enter into our calculations of required doses of vaccine. We assume that pandemic vaccines will have the same relationship between efficacy and immunogenicity as that for standard vaccines against human influenza virus.

• ↵ ¶ R ₀ is a difficult quantity to estimate during an actual epidemic, because it depends critically upon the disease serial interval (or generation time) and to a somewhat lesser extent on the relative durations of the latent and infectious periods (19, 20). Because our model assumes particular values for these quantities, R ₀ is a useful measure of transmissibility, but care needs to be taken when comparing results for different models or epidemiological data.

• Conflict of interest statement: No conflicts declared.

• Abbreviations:

  Abbreviations:

  TAP,

  targeted antiviral prophylaxis;

  NAI,

  neuraminidase inhibitor.

• © 2006 by The National Academy of Sciences of the USA