Traditional methods, such as washing hands and
wearing face masks, are also effective at controlling an outbreak
until vaccines are made available, researchers said.
“We saw what happened in 2009 and we wanted to take a look at if the
response was similar to that in a more severe pandemic episode how
prepared are we,” said Dr. Nayer Khazeni, the study’s lead author
from the Stanford University School of Medicine in California.
The World Health Organization declared in June 2009 that an outbreak
of the H1N1 influenza virus qualified as a pandemic, which is when a
virus circulates around the globe and most people do not have
immunity against it. The strain was referred to as “swine flu” early
Khazeni and her fellow researchers write in the Annals of Internal
Medicine that vaccination against H1N1 did not start until about
nine months after the outbreak began.
In a previous study, they found that every four-week delay in
vaccinations during that outbreak led to significant increases in
infections, deaths and costs.
The researchers used a computer model for the new study to estimate
what those figures might look like in a city like New York during a
more severe flu pandemic, depending on when the first 30 percent of
the population became vaccinated.
The pandemic used for the computer model was crafted like the 1918
Spanish flu pandemic, which killed an estimated 30 to 50 million
people globally, including 675,000 in the U.S.
The flu virus used in the model also borrowed traits from two
emerging bird flu viruses from Asia and the Middle East, H7N9 and
The researchers estimated that each person with the flu would infect
about two more.
About 48,250 people would die if it took a full year from the start
of the outbreak for 30 percent of a city with about 8 million people
to get vaccinated, according to the model.
About 45,890 people would die if vaccination took nine months – as
it did during the 2009 outbreak. Deaths would fall to about 34,480
if vaccination was pushed up to four months.
Healthcare costs would also fall by about $100 million city-wide if
widespread vaccination was moved from nine months to four months, or
almost $4 billion nationally.
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The researchers note that the current process to
create flu vaccines takes about five months under the best
circumstances, however. New technology that does not use eggs to
develop a vaccine may allow for shorter production times, they
“These figures may help policymakers decide
what scenarios warrant a concerted effort between vaccine
manufacturers and the government to speed production and
administration,” they add.
If speeding up vaccine production is not possible, the researchers
also found that non-drug techniques like wearing masks, washing
hands and staying in may control the outbreak until a vaccine is
“I think that’s a really encouraging finding,” Khazeni said.
Dr. Mark Mulligan, executive director of the Hope Clinic of the
Emory Vaccine Center in Atlanta, told Reuters Health that people
should know the best defense against the flu is prevention.
“That weapon - although not perfect - is the vaccine,” he said.
“People should be vaccinated annually and when there is a pandemic
we want to get as many people vaccinated as possible.”
Mulligan, who was not involved with the new study, also said it’s
important that people follow the advice that’s already known, such
as washing hands and coughing into the crook of the arm.
Annals of Internal Medicine, online May 19, 2014.
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