The cdc released guidance on allocating and targeting of pandemic influenza vaccine in july 2008. On june 11, 2009, who declared an official influenza pandemic phase 6, reflecting global spread of a new strain of human flu h1n1 virus. Influenza viruses caused four global pandemics 191819, 1957, 1968, and 2009 in the last century. The pip framework brings together member states, industry, other stakeholders and who to implement a global approach to pandemic influenza preparedness and response. In determining categories of prioritization for acc admission, the proposed cdc guidelines are informative in the designation of primary health policy goals and, correlatively, of distribution criteria that do or do not serve these goals and thus can be considered fair or unfair under the limited circumstances of a pandemic. Vaccination is the best option by which spread of a pandemic virus could be prevented and severity of disease reduced. Initial supplies of a new pandemic vaccine are unlikely to be sufficient to immediately supply.
Appendix j excerpts from the hhs pandemic influenza plan. Prioritization of delayed vaccination for pandemic influenza. Pandemic products such as antiviral medicines, vaccines and diagnostics play a critical role in the control and treatment of pandemic influenza. Due to a relative shortage of vaccine expected early in the pandemic, vaccine recipients will be prioritized.
Vaccine transfer of technology for pandemic influenza. Pandemic influenza plan centers for disease control and. Develop an analytical framework and model for prioritizing vaccines of domestic and global importance. Based on the schedule of vaccine availability projected by the cdc, we examined the various age and riskspecific allocation of vaccine doses, and compared the effectiveness of various vaccination schemes to the vaccination strategies recommended by the cdcs acip for h1n1 pandemic influenza a. Phacs pandemic vaccine prioritization framework mentions correctional facilities as a potential target for early vaccination because pandemic epidemiology might reveal prisoners to be a vulnerable population because of their susceptibility to severe illness public health agency of canada, 2009. Current status of planning for pandemic influenza and. The pandemic vaccine prioritization framework has been updated to provide more. The national vaccine advisory committee nvac and the advisory committee on immunization policy acip have jointly recommended a prioritization scheme that. Hhss recent guidance on allocating and targeting pandemic influenza vaccine also takes into account pandemic severity.
While scientific evidence underpins the framework, all criteria are relevant to the development of recommendations. Guidance development and revision pandemic influenza. Most people will have little to no immunity to a flu virus that has undergone an antigenic shift, and if the virus is easily spread from persontoperson, it can cause a global outbreak, called a pandemic. Vaccine distribution in the event of a pandemic, the public and private sectors will mobilize to produce and distribute vaccine, if one is available, as quickly as possible. We adapted a citylevel contact network model to study different campaigns on influenza morbidity and mortality. Prioritization strategies for pandemic influenza vaccine in. Ethical preparedness for pandemic influenza markkula center. Pandemic preparedness vaccines can be authorised but not marketed before an influenza pandemic. Geographic prioritization of distributing pandemic. Advance purchase agreements apas and subsequent procurement 2. Prioritize countermeasure allocation before an outbreak, and update this prioritization immediately after the outbreak begins based on the atrisk populations, available supplies and the characteristics of the virus. Nov 01, 2005 develop credible countermeasure distribution mechanisms for vaccine and antiviral agents prior to and during a pandemic.
Pdf geographic prioritization of distributing pandemic. Profound changes in the genetic makeup of an influenza virus lead to antigenic shift, which results in larger changes to the structure of the virus surface proteins. Global survey on national vaccine deployment and vaccination plans for pandemic ah1n1 2009 vaccine 2010 pdf, 865kb. Prioritizing vaccine access for vulnerable but stigmatized. In this first phase report, the iom offers a framework and proof of concept to account for various factors influencing vaccine prioritizationdemographic, economic, health, scientific, business. This technique allows infectious virus to be recovered from cells approved for use in human vaccine development socalled qualified cells. Gap implementation is supported by the pandemic influenza preparedness pip framework, an international agreement established in 2011 that facilitates equitable influenza virus and benefit sharing. The items in the checklist are based on the 2018 interim updated planning guidance on allocating and targeting pandemic influenza vaccine during an influenza pandemic, and include specific activities public health emergency planners and immunization programs can do to prepare for targeted pandemic influenza vaccination. The 2009 h1n1 vaccination recommendations in the us were based on the infection pattern of h1n1 influenza pandemic strain. Albertas ethical framework for responding to pandemic. National guidance for targeting pandemic influenza vacci. These vaccines either contained inactivated killed influenza virus, or weakened live virus that could not cause influenza.
This document provides guidance on the allocation of influenza vaccine during the early stages of a pandemic when demand may exceed production capacity. This template provides guidance to assist organizations in developing a pandemic influenza continuity of operations plan or, if the organization already has a continuity plan, a pandemic influenza annex. Pandemic influenza vaccine manufacturing process and timeline. May 18, 2012 pandemic influenza is an international public health concern. Initial supplies of a new pandemic vaccine are unlikely to be sufficient to immediately supply everyone living in canada. Anderson1 1mrc centre for outbreak control and analysis, department of infectious disease epidemiology, imperial college london, london, united kingdom, 2theoretical. Pandemic influenza is an international public health concern.
Recommendations for priority groups will be made at the national level, which will be adapted by kdhe. The first doses are expected to be available in five to six months from the identification of the pandemic strain, i. Albertas ethical framework for responding to pandemic influenza ab ethics framework is based on the extensive work completed by british columbia, the uk, and alberta. When a novel, pandemic strain occurs, only a small supply of vaccine, if any, is likely to be available, and once vaccine production begins it will be at a rate that will allow immunization of. We derive a mathematical decision framework to track the effectiveness of prioritized vaccination through the course of a pandemic. Pip framework secretariats strategic approach of prioritizing.
The objective of the pandemic influenza preparedness framework is to improve pandemic influenza preparedness and response, and strengthen the protection. Joint statement on global pandemic preparedness c20 saudi. Request pdf prioritization of delayed vaccination for pandemic influenza limited production capacity and delays in vaccine development are major obstacles to vaccination programs that are. Box s1 committee on identifying and prioritizing new preventive vaccines for development.
Pandemic personal protective equipment ppe allocation framework this document guides health care providers in determining what type of ppe individuals working or visiting in health care settings will receive in the event of a pandemic when demand for ppe overwhelms supply. National deployment and vaccination plans for pandemic influenza vaccines are national tools which ensure that during a pandemic, processes and structures are functional so that vaccines are rapidly deployed and administered to target populations. The pandemic vaccine prioritization framework consists of a series of criteria organized into categories, with key questions identified for each of the criteria table a1. The cdcs advisory committee on immunization practices and other governmental and advisory groups will issue national guidelines prioritizing who should be vaccinated. Framework as a novel international instrument to strengthen the sharing of influenza viruses with human pandemic potential while increasing the preparedness of developing countries, and their access to vaccines and other pandemic related supplies in the event of a pandemic. However, in a pandemic scenario as was the case in the 2009 h1n1 pandemic, the federal government will contract directly with vaccine manufacturers to develop safe and effective pandemic influenza vaccine for the entire us population. Appendix j excerpts from the hhs pandemic influenza plan, appendix d nvacacip recommendations for prioritization of pandemic influenza vaccine and nvac recommendations on pandemic antiviral drug use the priority group recommendations are currently under revision source. Equalizing access to pandemic influenza vaccines through. This document guides health care providers in determining what type of ppe individuals working or visiting in health care settings will receive in the event of a pandemic when demand for ppe overwhelms supply.
Utilitarianism and utilitarian principles for rationing. Interim updated planning guidance on allocating and targeting pandemic influenza vaccine. Tier 1 includes the highest priority population groups identified in each of the four categories and may vary based on pandemic severity and supply. Vaccine prioritization for effective pandemic response.
Whoeurope pandemic influenza preparedness pip framework. The killed vaccine was injected, while the live vaccine was given as a nasal spray. We examined aggregate usage and median usage of vaccine by country. Does having a seasonal influenza program facilitate pandemic. Clinical studies on a17california200938 h1n1 and licensing of the russiandeveloped technology to who for pandemic influenza preparedness in developing countries. Does having a seasonal influenza program facilitate. A worksheet to ensure youre not forgetting any employees when estimating your clinics need for pandemic influenza vaccine. Dec 14, 2011 much remains unknown about the effect of timing and prioritization of vaccination against pandemic ph1n1 2009 virus on health outcomes. Pandemic personal protective equipment ppe allocation framework. Revised guidance for allocating and targeting initial vaccination of certain groups includes a structure, as in the 2008 guidance, that defines population groups in four broad categories that correspond with the objectives of a pandemic vaccination program to protect people who 1 maintain homeland and national security, 2 provide health. Prioritization strategies for pandemic influenza vaccine in 27. The 2009 flu pandemic vaccines were influenza vaccines developed to protect against the pandemic h1n109 virus. Prioritization of delayed vaccination for pandemic. Geographic prioritization of distributing pandemic influenza vaccines article pdf available in health care management science 153.
Apr 24, 2018 new vaccine production technologies can significantly shorten the timelines for availability of a strainspecific vaccine in the event of an influenza pandemic. This framework can be used to assist in making decisions on common pandemic influenzarelated ethical dilemmas such as vaccine priority decisions, compensation for health care workers, antiviral prioritization and many others. The national vaccine advisory committee nvac and the advisory committee on immunization policy acip have jointly recommended a prioritization scheme. Assessing the benefits of early pandemic influenza vaccine. Seasonal influenza affects all member states and causes an estimated global burden of 290,000650,000 respiratory deaths each year. Public health experts agree that the best strategy to contain a pandemic, where vaccination is the prophylactic treatment but vaccine supply is limited, is to give higher priority to higherrisk populations. Vaccines for pandemic influenza centers for disease. The ah1n1 pandemic of 2009 demonstrated that influenza activity and severity might vary considerably among. When more vaccines became available and the demand for vaccine for the prioritized groups was met, vaccines were given to everyone from the ages of 25 to 64. Allocating and targeting pandemic influenza vaccine during. We modeled different distribution strategies initiated between july and november 2009 using a compartmental epidemic model that includes age. Effects of vaccine program against pandemic influenza ah1n1. General guidance and sample information is provided for reference and organizations are.
Canadas pandemic influenza vaccine strategy is built upon the strength of the seasonal influenza programs. Joint statement on global pandemic preparedness c20. Cfe and pef, multilateral and bilateral aid agencies, governments, private sector, and civil society. T he potential threat of pandemic influenza is staggering. These results em phasize the need for relevant surveillance data to facilitate a rapid evaluation of vaccine recommendations and effects.
Kansas pandemic influenza preparedness and response plan. Roadmap for vaccination of critical workforce personnel. Since that time, our nation has experienced, and learned from, the 2009 influenza ah1n1 pandemic and the emergence of other influenza viruses of concern, such as h7n9 that emerged in 20 in china and continues to cause periodic outbreaks. In a classic work dealing with just rationing of scarce medical resources, gerald winslow contrasts the strengths and weaknesses of utilitarianism and egalitarianism.
Pandemic influenza preparedness aims to strengthen country, regional and global capacities. In most public plans the criteria by which prioritized groups are identified are not easily recognizable. Therefore, it is increasingly important for decision makers to have the tools that can assist and inform their vaccine prioritization efforts. While pandemic vaccine production can only start once the pandemic virus has been recognized, pandemic vaccine capacity will be limited at least during the first phase of the pandemic.
At the time of the plans writing, the nation was wholly unprepared to address the significant medical and. Allocating and targeting pandemic influenza vaccine during an influenza pandemic. For scenarios where the only vaccination option is traditional pandemic influenza vaccine with availability starting 6 months after the emergence of the pandemic strain and 3. The distribution of limited and progressively available vaccine supply will require strategies for vaccine prioritization, i. Prioritizing vaccine access for vulnerable but stigmatized groups. Prioritization strategies for pandemic influenza vaccine. Vaccines for pandemic influenza european medicines agency. Capabilities4 provides a capabilitybased framework to help. In april 2009, the united states began a response to the emergence of a pandemic influenza virus strain. Therefore, pandemic vaccine capacity will be limited at least during the first phase of an influenza pandemic, requiring vaccine prioritization strategies. However, as during the 2009 h1n1 pandemic, mass immunization with an effective vaccine may not begin until a pandemic is well underway. The pandemic influenza preparedness framework for the sharing of influenza viruses and access to vaccines and other benefits pip framework brings together member states, industry, other stakeholders and who to implement a global approach to pandemic influenza preparedness and response. The overall median usage of pandemic vaccine was 76%, with no significant difference by region, income classification, and vaccine delivery category. This document was developed to update and provide interim guidance for planning purposes and to provide the rationale for a national vaccination program during a pandemic that also allows for local adjustment where appropriate.
Pandemic influenza preparedness framework for the sharing of influenza viruses and access to vaccines and other benefits. The ah1n1 pandemic of 2009 demonstrated that influenza activity and severity might vary considerably among age groups and. Early vaccine availability represents an important public. Much remains unknown about the effect of timing and prioritization of vaccination against pandemic ph1n1 2009 virus on health outcomes.
O n april 26, 2009, the united states declared a public health emergency in response to the 2009 pandemic in fluenza ah1n1pdm09 virus 1. By using us surveillance data april 12, 2009april 10, 2010 and vaccine coverage estimates october 3, 2009april 18, 2010, we estimated that the ah1n1pdm09 virus vaccination program prevented 700,0001,500,000 clinical cases. In the event of a pandemic, once the virus strain causing the pandemic is identified, the manufacturer can include this strain in the authorised pandemic preparedness vaccine and apply for the vaccine to be authorised as a final pandemic vaccine. Main operational lessons learnt from the who pandemic influenza ah1n1 vaccine deployment initiative report of a who meeting held in geneva, switzerland, 15 december 2010. A guide for state, local and territorial and tribal planners december 2006, produced by cdcs immunization service division, as well as the document status of pandemic influenza vaccine manufacturing capacity, prepandemic stockpile, and planning for vaccine. Effects of vaccine program against pandemic influenza a. A framework of seven ethical points was presented that the center believes the state should consider when formulating policy in response to an influenza pandemic. We modeled different distribution strategies initiated between july and november 2009 using a compartmental epidemic model that. Geographic prioritization of distributing pandemic influenza.
The implications of the h5n1 vaccine trial results for pandemic vaccine supply are extremely discouraging, even for vaccineproducing countries. Allocating and targeting pandemic influenza vaccine cdc. Assessment report on euwide pandemic vaccine strategies. May 12, 2006 t he potential threat of pandemic influenza is staggering. Framework for targeting pandemic influenza vaccine. The aim is to reduce the gap between the potential vaccine demand and supply anticipated during an influenza pandemic. Vaccination against 2009 pandemic h1n1 in a population. Work is underway to develop a vaccine for the pandemic influenza ah1n1 virus. In this first phase report, the iom offers a framework and proof of concept to account for various factors influencing vaccine prioritization demographic, economic, health, scientific, business. Data on vaccine usage were available from 61 79% of the 77 countries that received vaccine. You, your public health department and the next flu pandemic. Albertas ethical framework for responding to pandemic influenza. Winslow offers a framework which is useful for considering the rationing of influenza vaccine in light of a pandemic.
Interim updated planning guidance on allocating and. Allocating and targeting pandemic influenza vaccine. Phacs pandemic vaccine prioritization framework mentions correctional facilities as a potential target for early vaccination because pandemic epidemiology might reveal prisoners to be a vulnerable population because of their susceptibility to severe. Given the usual 6month vaccine production cycle and current u. The last pandemic influenza plan for the department of health and human services update was issued in 2009. In light of the persistent threat of h5n1 avian influenza and the recent pandemic of ah1n1swine influenza outbreak, public health agencies around the globe are continuously revising their preparedness plans. Review of the pandemic influenza preparedness framework. Although there is rapid progress in vaccine research regarding influenza pandemic vaccines it is expected that pandemic influenza vaccine production can only start once the pandemic virus has been recognized. New vaccine production technologies can significantly shorten the timelines for availability of a strainspecific vaccine in the event of an influenza pandemic.
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