For current pandemic influenza H1N1, vaccine production started in the early summer, and vaccination started in the fall. In most countries, by the time vaccination started, the second wave of H1N1 was already under way. With limited supplies of vaccine, it might be a good strategy to vaccinate the high-transmission groups earlier in the epidemic, but it might be a better use of resources to protect instead the high-risk groups later on. We develop a deterministic epidemic model with two age-groups (children and adults) and further subdivide each age group in low and high risk. We compare optimal vaccination strategies started at various points in time in two different settings: a population in the United States (US) where children account for 24% of the population, and a population in Senegal, where children make up for the majority of the population, 55%. For each of these populations, we minimize mortality and we find an optimal vaccination vector that gives us the best vaccine allocation given a starting vaccination date and vaccine coverage level. We find that there is a switch in the optimal vaccination strategy at some time point just before the peak of the epidemic. For instance, with 25% vaccine coverage, it is better to protect the high-transmission groups before this point, but it is optimal to protect the most vulnerable groups afterward.


Disease Modeling