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July 16, 1999
Hard choices: who should get influenza vaccine first in a pandemic?
Being prepared for the next influenza pandemic may mean that public health officials
will have to make hard choices in deciding who should be first to get vaccinated.
ATLANTA—The next influenza pandemic—public health officials agree that it's a
question of "when" rather than "if"—could cause as many as 89,000
to 207,000 deaths in the United States, with economic losses ranging from $71.3 billion to
$166.5 billion, according to an article in the upcoming issue of Emerging Infectious
Diseases, CDC's peer-reviewed journal, which tracks new and reemerging infectious diseases
worldwide.
Three influenza pandemics have occurred in the 20th century. The one in 1918 resulted
in more than 20 million deaths worldwide. Being prepared means vaccination, but it may be
impossible to give shots to everyone at the same time.
The authors of this report used a mathematical model to calculate the number of
illnesses and deaths that could result from a pandemic. The model took into account the
cost to society of a pandemic without any planned intervention. Then it measured the costs
and benefits of giving vaccine to different age groups and groups at high risk.
If a pandemic were to strike, more than half of the deaths would probably be among
persons 65 years of age or older. However, younger age groups could also be hard hit, as
occurred in 1918 and other pandemics. If preventing the greatest number of deaths is the
most important goal, persons in the groups at high risk should be vaccinated first,
followed by everyone 65 years of age or older. If the highest priority is protecting the
productivity of the workplace, persons 64 years of age and younger should be vaccinated
first.
The amount that should be spent each year to plan, prepare, and practice for mass
vaccination can be seen as an annual insurance premium. Being prepared means improving
systems to detect illness, making sure that enough vaccine is available, and developing
plans for emergency response.
For more information, contact Dr. Martin Meltzer at 404-629-3039 (fax). Access the full
article at http://www.cdc.gov/ncidod/eid/vol5no5/meltzer.htm.
All material in Emerging Infectious Diseases is in the public domain and may be used
without special permission; proper citation, however, is appreciated.
For more information on this or related topics, see—
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