Early vaccination could reduce morbidity, mortality, and health care costs associated with pandemic flu, according to an article being published in Annals of Internal Medicine.

Response to a 2009 H1N1 pandemic was not optimal, with large-scale vaccination not occurring until nine months after outbreak. Using lessons learned from the 2009 pandemic, researchers sought to determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a pandemic with characteristics similar to influenza A (H7N9) and A (H5N1), which are associated with high mortality rates. Researchers used a computer model to estimate the health and economic consequences of a severe outbreak in a large metropolitan U.S. city with demographic characteristics similar to those of New York City. The population was assumed to have no preexisting immunity. The researchers considered various timing options for pharmaceutical interventions (vaccination) coupled with nonpharmaceutical interventions (facemasks, hand washing, social distancing). They found that vaccinating at six months after the start of the outbreak instead of nine would prevent more than 230,000 infections and almost 6,000 additional deaths in a city of 8.3 million people. The city would also save $51 million in medical costs.

Additional measures, such as wearing face masks, washing hands or closing schools, can limit the virus's spread while a vaccine is in production. The researchers conclude that vaccination timing is crucial, and there is an optimal window for large-scale pandemic vaccination. A delay of just four weeks leads to substantial increases in infection, deaths, and costs.

Article: Health and Economic Benefits of Early Vaccination and Nonpharmaceutical Interventions for a Human Influenza A (H7N9) Pandemic: A Modeling Study, N. Khazeni, D.W. Hutton, C.I. F. Collins, A.M. Garber, and D.K. Owens.