Abstract
In response to the 2007-2009 Haemophilus influenzae type b (Hib) vaccine shortage in the United States, we developed a flexible model of Hib transmission and disease for optimizing Hib vaccine programs in diverse populations and situations. The model classifies population members by age, colonization/disease status, and antibody levels, with movement across categories defined by differential equations. We implemented the model for the United States as a whole, England and Wales, and the Alaska Native population. This model accurately simulated Hib incidence in all 3 populations, including the increased incidence in England/Wales beginning in 1999 and the change in Hib incidence in Alaska Natives after switching Hib vaccines in 1996. The model suggests that a vaccine shortage requiring deferral of the booster dose could last 3 years in the United States before loss of herd immunity would result in increasing rates of invasive Hib disease in children <5 years of age.
Highlights
Invasive Haemophilus influenzae (Hi) disease: isolation of Haemophilus influenzae from normally sterile site in a resident of a surveillance area in 2001
Standardized case report forms that include information on demographic characteristics, clinical syndrome, and outcome of illness were completed for each identified case
Serotyping was done on Hi isolates at CDC and state laboratories
Summary
Project personnel communicated at least monthly with contacts in all microbiology laboratories serving acute care hospitals in their area to identify cases. Standardized case report forms that include information on demographic characteristics, clinical syndrome, and outcome of illness were completed for each identified case. Serotyping was done on Hi isolates at CDC and state laboratories. Regular laboratory audits assess completeness of active surveillance and detect additional cases. All rates of invasive Hi disease were calculated using population estimates for 2001. Raceand age-specific rates of disease were applied from the aggregate surveillance areas to the race- and age-specific distribution of the 2001 U. Cases with unknown race were distributed by area based on reported race distribution for known cases within the eight age categories
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