Deriving effective vaccine allocation strategies for pandemic influenza: Comparison of an agent-based simulation and a compartmental model.

Individuals are prioritized based on their risk profiles when allocating limited vaccine stocks during an influenza pandemic. Computationally expensive but realistic agent-based simulations and fast but stylized compartmental models are typically used to derive effective vaccine allocation strategies. A detailed comparison of these two approaches, however, is often omitted. We derive age-specific vaccine allocation strategies to mitigate a pandemic influenza outbreak in Seattle by applying derivative-free optimization to an agent-based simulation and also to a compartmental model. We compare the strategies derived by these two approaches under various infection aggressiveness and vaccine coverage scenarios. We observe that both approaches primarily vaccinate school children, however they may allocate the remaining vaccines in different ways. The vaccine allocation strategies derived by using the agent-based simulation are associated with up to 70% decrease in total cost and 34% reduction in the number of infections compared to the strategies derived by using the compartmental model. Nevertheless, the latter approach may still be competitive for very low and/or very high infection aggressiveness. Our results provide insights about potential differences between the vaccine allocation strategies derived by using agent-based simulations and those derived by using compartmental models

Input parameters of FluTe and the SEIR model.

<p>Input parameters of FluTe and the SEIR model.</p

Vaccine allocation strategies for different response time scenarios.

<p>Vaccine allocation strategies for different response time scenarios.</p

Cumulative number of infections in each age group of FluTe and the SEIR model after the calibration process for <i>R</i>₀ = 1.2 without vaccination.

<p>(a) Total population. (b) Preschool children (0–4). (c) School children (5–18). (d) Young adults (19–29). (e) Adults (30–64). (f) Seniors (65+).</p

Vaccine allocation strategies for different coverage scenarios.

<p>Vaccine allocation strategies for different coverage scenarios.</p

Objective values of recommended vaccine allocation strategies.

<p>Objective values of recommended vaccine allocation strategies.</p

Vaccine allocation strategies obtained by FluTe+MADS and SEIR+MADS under the base-case scenario.

<p>Vaccine allocation strategies obtained by FluTe+MADS and SEIR+MADS under the base-case scenario.</p

Vaccine allocation strategies derived by FluTe+MADS and SEIR+MADS under all objective functions for various R₀ values (30% vaccine coverage, no delay in response time).

<p>(a) SEIR+MADS with the TC objective. (b) FluTe+MADS with the TC objective. (c) SEIR+MADS with the TI objective. (d) FluTe+MADS with the TI objective. (e) SEIR+MADS with the TD objective. (f) FluTe+MADS with the TD objective. (g) SEIR+MADS with the TY objective. (h) FluTe+MADS with the TY objective.</p

Gender-related clinical and management differences in patients with chronic heart failure with reduced ejection fraction

Aim Gender-related differences have been described in the clinical characteristics and management of patients with chronic heart failure with reduced ejection fraction (HFrEF). However, published data are conflictive in this regard