Tennenbaum Stephen
Department of Mathematics and Statistics, Arizona State University, Tempe, AZ 85287, USA.
J Theor Biol. 2008 Feb 21;250(4):673-83. doi: 10.1016/j.jtbi.2007.10.021. Epub 2007 Oct 24.
Strategies for best controlling the spread of the diseases with limited vaccine available are explored. I use influenza as a representative disease in point. The model describes the dynamics of influenza spread among multiple groups that have different risks and activity levels. I define a core group consisting of individuals with occupations that brings them in contact with many other people in a day. These occupations may include service industries, teachers, health care, and government workers, to name a few. High-risk individuals are those as typically designated for: children under 5 and adults over 50, people with weakened immune systems as well as emergency and health care personnel. Under certain conditions, shifting vaccination resources away from the high-risk group to the high-activity group will result in improved herd immunity in both the high-risk group and the population as whole. This results in more high-risk people protected even though less of them are being vaccinated, with the obvious implications that current vaccination policies may be far less then optimal. I show that the criteria for the optimal strategy can be derived from simple expressions gleaned from the expression for the basic reproductive number.
探讨了在可用疫苗有限的情况下最佳控制疾病传播的策略。我以流感作为一个典型疾病为例。该模型描述了流感在具有不同风险和活动水平的多个群体之间传播的动态情况。我定义了一个核心群体，该群体由那些职业使他们每天与许多其他人接触的个体组成。这些职业可能包括服务业、教师、医疗保健人员和政府工作人员等等。高风险个体通常是指：5岁以下儿童和50岁以上成年人、免疫系统较弱的人以及急救和医疗保健人员。在某些情况下，将疫苗接种资源从高风险群体转移到高活动群体将导致高风险群体和整个人口中的群体免疫得到改善。这意味着即使接种疫苗的高风险人群减少了，也会有更多的高风险人群得到保护，这显然意味着当前的疫苗接种政策可能远非最优。我表明，最优策略的标准可以从从基本繁殖数的表达式中收集的简单表达式推导出来。
