University of Pittsburgh, 200 Meyran Avenue, Pittsburgh, PA 15213, USA.
Am J Prev Med. 2010 Mar;38(3):247-57. doi: 10.1016/j.amepre.2009.11.009. Epub 2009 Dec 30.
Better understanding the possible effects of vaccinating employees is important and can help policymakers and businesses plan vaccine distribution and administration logistics, especially with the current H1N1 influenza vaccine in short supply.
This article aims to determine the effects of varying vaccine coverage, compliance, administration rates, prioritization, and timing among employees during an influenza pandemic.
As part of the H1N1 influenza planning efforts of the Models of Infectious Disease Agent Study network, an agent-based computer simulation model was developed for the Washington DC metropolitan region, encompassing five metropolitan statistical areas. Each simulation run involved introducing 100 infectious individuals to initiate a 1.3 reproductive-rate (R(0)) epidemic, consistent with H1N1 parameters to date. Another set of scenarios represented a R(0)=1.6 epidemic.
An unmitigated epidemic resulted in substantial productivity losses (a mean of $112.6 million for a serologic 15% attack rate and $193.8 million for a serologic 25% attack rate), even with the relatively low estimated mortality impact of H1N1. Although vaccinating Advisory Committee on Immunization Practices-defined priority groups resulted in the largest savings, vaccinating all remaining workers captured additional savings and, in fact, reduced healthcare workers' and critical infrastructure workers' chances of infection. Moreover, although employee vaccination compliance affected the epidemic, once 20% compliance was achieved, additional increases in compliance provided less incremental benefit. Even though a vast majority of the workplaces in the DC metropolitan region had fewer than 100 employees, focusing on vaccinating only those in larger firms (> or =100 employees) was just as effective in mitigating the epidemic as trying to vaccinate employees in all workplaces.
Timely vaccination of at least 20% of the large-company workforce can play an important role in epidemic mitigation.
更好地了解为员工接种疫苗可能产生的影响很重要，这有助于政策制定者和企业规划疫苗分发和管理工作，尤其是在当前 H1N1 流感疫苗供应短缺的情况下。
本文旨在确定在流感大流行期间为员工接种疫苗时，不同疫苗覆盖率、接种率、管理率、优先级和时间安排的影响。
作为传染病agent 研究网络 H1N1 流感规划工作的一部分，我们为华盛顿特区大都市区（包含五个大都市统计区）开发了一个基于 agent 的计算机模拟模型。每次模拟运行涉及向系统中引入 100 名传染性个体，以引发 1.3 代（R(0)）的传染病流行，与迄今为止的 H1N1 参数一致。另一组情景代表 R(0)=1.6 的传染病流行。
在未采取缓解措施的情况下，即使 H1N1 的估计死亡率影响相对较低，仍会导致严重的生产力损失（血清学 15%发病率的平均损失为 1.126 亿美元，血清学 25%发病率的平均损失为 1.938 亿美元）。尽管为免疫接种咨询委员会（Advisory Committee on Immunization Practices，ACIP）定义的优先群体接种疫苗可节省最多的费用，但为所有剩余员工接种疫苗可节省更多的费用，并且实际上降低了医护人员和关键基础设施工作人员的感染几率。此外，尽管员工接种疫苗的依从性会影响传染病流行，但一旦达到 20%的依从性，增加更多的依从性只会带来较少的增量效益。尽管华盛顿特区大都市区的大多数工作场所的员工人数少于 100 人，但集中为大型企业（员工人数>或=100 人）接种疫苗与试图为所有工作场所的员工接种疫苗一样，在缓解传染病方面同样有效。
及时为至少 20%的大型企业员工接种疫苗，可以在传染病缓解方面发挥重要作用。
