eprintid: 3777
rev_number: 12
eprint_status: archive
userid: 69
dir: disk0/00/00/37/77
datestamp: 2017-09-04 14:28:17
lastmod: 2017-09-04 14:28:17
status_changed: 2017-09-04 14:28:17
type: conference_item
metadata_visibility: show
creators_name: Betta, Monica
creators_name: Laurino, Marco
creators_name: Pugliese, Andrea
creators_name: Guzzetta, Giorgio
creators_name: Landi, Alberto
creators_name: Manfredi, Piero
creators_id: monica.betta@imtlucca.it
creators_id: 
creators_id: 
creators_id: 
creators_id: 
creators_id: 
title: Optimal Varicella immunization programs for both Varicella and Herpes Zoster Control
ispublished: pub
subjects: QA
subjects: QA75
subjects: QH301
subjects: R1
divisions: CSA
full_text_status: none
pres_type: paper
abstract: A main obstacle to the widespread adoption of varicella immunization in Europe has been the fear of a subsequent boom in natural herpes zoster caused by the decline in the protective effect of natural immunity boosting due to reduced virus circulation. We apply optimal control to simple models for VZV transmission and reactivation to investigate existence and feasibility of temporal paths of varicella childhood immunization that are optimal in controlling both varicella and zoster. We analyze the optimality system numerically focusing on the role played by the structure of the cost functional, the relative cost zoster-varicella, and the length of the planning horizon. We show that optimal programs exist but will mostly be unfeasible in real public health contexts due to their complex temporal profiles. This complexity is the consequence of the intrinsically antagonistic nature of varicella immunization programs when aimed to control both varicella and herpes zoster. However we could show that gradually increasing, smooth – thereby feasible - vaccination schedules, can perform largely better than routine programs with constant vaccine uptake. Moreover we show the optimal temporal profiles of feasible immunization
programs targeting with priority the mitigation of the post-immunization natural zoster boom.
date: 2015
event_title: Erice MathCompEpi 2015
event_location: Erice, Italy
event_dates: August 30 - September 5, 2015
event_type: conference
refereed: FALSE
book_title: Mathematical and computational Epidemiology ERICE 2015
official_url: https://erice2015.files.wordpress.com/2015/08/ericemathcompepi2015_abstracts_aug251.pdf
citation:   Betta, Monica and Laurino, Marco and Pugliese, Andrea and Guzzetta, Giorgio and Landi, Alberto and Manfredi, Piero  Optimal Varicella immunization programs for both Varicella and Herpes Zoster Control.  In: Erice MathCompEpi 2015, August 30 - September 5, 2015, Erice, Italy         (2015)