Maximizing the effectiveness of a pediatric vaccine formulary while prohibiting extraimmunization.

The growing-complexity of the United States Recommended Childhood Immunization Schedule has resulted in as many as five required injections during a single well-baby office visit. To reduce this number, vaccine manufacturers have developed combination vaccines that immunize against several diseases...

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Publicado en:Health Care Management Science Vol. 11; no. 4; pp. 339 - 353
Autores principales: Hall SN, Sewell EC, Jacobson SH, Hall, Shane N, Sewell, Edward C, Jacobson, Sheldon H
Formato: research Journal Article
Publicado: Springer Nature Dec2008
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Maximizing the effectiveness of a pediatric vaccine formulary while prohibiting extraimmunization.
      aug:
        au:
          Hall SN
          Sewell EC
          Jacobson SH
          Hall, Shane N
          Sewell, Edward C
          Jacobson, Sheldon H
        affil: Department of Operational Sciences, Air Force Institute of Technology, 2950 Hobson Way, Wright-Patterson AFB, OH 45433-7765, USA
      sug:
        subj:
          Algorithms
          Immunization Statistics and Numerical Data
          Vaccines Administration and Dosage
          Child
          Immunization Schedule
          Child: 6-12 years
      ab: The growing-complexity of the United States Recommended Childhood Immunization Schedule has resulted in as many as five required injections during a single well-baby office visit. To reduce this number, vaccine manufacturers have developed combination vaccines that immunize against several diseases in a single injection. At the same time, a growing number of parents are challenging the safety and effectiveness of vaccinating children. They are also particularly concerned about the use of combination vaccines, since they believe that injecting a child with multiple antigens simultaneously may overwhelm a child's immune system. Moreover, combination vaccines make it more likely that extraimmunization (i.e., administering more than the required amount of vaccine antigens) occurs, resulting in greater concerns by parents and vaccine wastage costs borne by an already strained healthcare system. This paper formulates an integer programming model that solves for the maximum number of vaccines that can be administered without any extraimmunization. An exact dynamic programming algorithm and a randomized heuristic for the integer programming model is formulated and the heuristic is shown to be a randomized xi-approximation algorithm. Computational results are reported on three sets of test problems, based on existing and future childhood immunization schedules, to demonstrate their computational effectiveness and limitations. Given that future childhood immunization schedules may need to be solved for each child, on a case-by-case basis, the results reported here may provide a practical and valuable tool for the public health community.
      pubtype: Academic Journal
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        research
        Journal Article
      ougenre: Article
    language: English
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