Formal Decision Analysis Process for Prioritizing Pandemic Influenza Vaccine in the United States

Learning Objectives for this Presentation:
Describe the need for a rigorous decision-analysis process to prioritize pandemic influenza vaccine
Identify and describe the key findings of the federal decision-analysis process
Identify how a decision-analysis process assists planners in prioritizing populations for influenza vaccine.

Background:
Given the limited amount of vaccine that will be initially available, the US Federal Government needs an effective prioritization strategy to allocate this resource. As a result, the Department of Health and Human Services and the Department of Homeland Security convened an interagency working group to develop a revised pandemic influenza vaccine allocation strategy. The working group sought assistance from UC Berkeley Center for Infectious Disease Preparedness and the California Department of Public Health to develop a formal decision analysis process for pandemic vaccine prioritization.

Objectives:
Engage in a rigorous decision analysis process to evaluate the objectives of the federal vaccine prioritization strategy and determine the degree to which protecting population groups meets these objectives.

Methods:
A decision analysis survey was administered to the federal working group who rated the importance of the 10 pandemic influenza vaccination program objectives. In addition, working group members evaluated 57 distinct population groups on how well they met program objectives related to occupational roles and risks. Prioritization scores for each population group were totaled across the 10 objectives and arranged into a rank-ordered list. This list was divided into 4 prioritization sub-categories.

Results:
Population groups with the highest prioritization scores, regardless of pandemic severity, included front-line public health responders and medical care providers, emergency medical services providers, law enforcement personnel, and vaccine manufacturers. For the general public category, infants and toddlers, and young children ranked highest.

Conclusions:
The results from this formal decision-analysis process represented one key component of the federal government pandemic vaccine prioritization process. These results were used to develop a revised Federal guidance for allocating pandemic influenza vaccine.