Optimal Vaccine Stockpile Design for an Eradicated Disease: Application to Polio
by Radboud J. Duintjer Tebbens, Mark A. Pallansch, James P. Alexander, Kimberly M. Thompson, Vaccine 2010; 28:4312-4327. PDF
Media coverage of this study included an article in the Emerging Health Threats Forum.

Answers to frequently asked questions

What are the study’s main findings?
What are the study’s main recommendations?
Background on polio

What are the study’s main findings?

• Few modeling studies address the complexity of vaccine stockpile management, bet the general analytical framework offered by this paper for optimization of a vaccine stockpile for an eradicated disease highlights several critical issues and demonstrates application of the framework to the global poliovirus vaccine stockpile for the post-eradication era.
• Optimization of a vaccine stockpile means finding the optimal balance between investments in the stockpile and public health costs associated with excess disease cases due to unmet vaccine needs. From an economic perspective, if unmet vaccine needs translate into high expected public health costs, then we should be willing to invest significantly in the stockpile.
• Key issues identified by the paper that require explicit discussion with respect to formulation of an optimal stockpile design includ the dynamics and uncertainty of vaccine demand, the risks associated with vaccine production in different locations after eradication, the nature of production and filling delays and the expiry process, serotype-dependence, and funding issues.
• In the case of polio, the stockpile size itself drives the demand: if the stockpile does not contain sufficient vaccine to contain outbreaks, then this leads to more demand and more vaccine shortage.
• Mathematical optimization using linear programming is possible under certain assumptions, but optimizing a more general model requires simulation and the use of heuristics.
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• Full optimization of the poliovirus vaccine stockpile will require the use of an expanded model to address the complex dynamics.
• Stockpile managers should apply the general analytical framework presented in this paper when considering the development of a vaccine stockpile for other eradicable or vaccine-preventable diseases.
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