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APHA Scientific Session and Event Listing

Lori Uscher Pines, MSc, Health Policy and Management, Johns Hopkins University, 1358 Indian Creek Dr, Wynnewood, PA 19096, 202-577-5083, luscher@jhsph.edu, Saad B. Omer, MBBS, MPH, Department of International Health, Johns Hopkins University, 615 N. Wolfe Street, Room 5507, Baltimore, MD 21205, Daniel J. Barnett, MD, MPH, Department of Environmental Health Sciences, Johns Hopkins University, 615 N. Wolfe Street, Room E2148, Baltimore, MD 21205, Thomas A. Burke, MPH, PhD, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 484, Baltimore, MD 21205, and Ran Balicer, MD, MPH, Epidemiology Department, Ben-Gurion University of the Negev, 27 Hagilgal St, Ramat-Gan, 52392, Israel.

Background: The aim of this research was to analyze the global variation in the prioritization of vaccines and antiviral medications in the context of pandemic influenza planning and to inform national level planning processes

Methods: We conducted a systematic document analysis of 45 national pandemic influenza plans from developed and developing nations published on the Internet or available through contacts at ministries of health. Plans available in English, Spanish, French, or German that addressed the issue of pandemic influenza were included.

Results: Within the 45 plan sample, 28(62%) prioritized vaccine for distribution and 22(49%) prioritized antivirals, as encouraged by WHO. Thirteen (29%) prioritized neither pharmaceutical intervention. Among nations that prioritized vaccine, thirteen (47%) prioritized children, thereby deviating from WHO recommendations. Eleven (50%) plans preferred the antiviral distribution strategy of treatment for ill patients to prophylaxis, as suggested by WHO in the context of resource-poor settings. Seven (32%) plans did not differentiate between these antiviral distribution strategies.

Conclusions: Considerable variation exists with respect to if and in what manner developed and developing nations are prioritizing vaccine and antiviral distribution. As stockpiles grow, the act of priority setting is gaining importance in pandemic planning. Furthermore, nations are deviating from WHO guidelines. Guidelines based on purely epidemiology-based reasoning that ignore local sociocultural preferences are insufficient in the context of national planning. Because nations are prioritizing to very different levels of detail (i.e. some are explicitly ranking disparate population groups), the risk communication implications of exhaustively detailed prioritization should be assessed.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify areas of variation (and similarity) across national influenza plans with respect to the prioritization of scarce medical resources
• Describe how and to what extent national vaccine and antiviral prioritization schemes deviate from World Health Organization guidelines
• Discuss recommendations for ongoing pandemic planning at the national level

Keywords: Policy/Policy Development, Infectious Diseases

Presenting author's disclosure statement:

Not Answered