Managing Uncertainty in Emergency Vaccination Campaigns for FMD

Quantifying the Value of Perfect
Information in Emergency Vaccination
Campaigns for FMD
Bradbury, N.V., Probert, W.J.M., Shea, K., Runge, M.C., Fonnesbeck, C.J.,
Keeling, M.J., Ferrari, M.J. & 
Tildesley, M.J.
*
Value of information (VOI)  analysis
During outbreaks research focuses on analysing the dynamics of that outbreak
Value of information (VOI)  analysis
During outbreaks research focuses on analysing the dynamics of that outbreak
Between outbreaks we can increase our knowledge so there is less uncertainty in
future outbreaks
Value of information (VOI)  analysis
During outbreaks research focuses on analysing the dynamics of that outbreak
Between outbreaks we can increase our knowledge so there is less uncertainty in
future outbreaks
The use of emergency FMD vaccination as a control measure has been contentious,
partly due to uncertainty
So how do we deal with uncertainty when making predictions
regarding control?
Uncertainty surrounding emergency vaccination
How does emergency vaccination work in livestock?
 
How effective is the vaccine?
 
How long is the delay between vaccination and immunity?
Uncertainty surrounding emergency vaccination
How does emergency vaccination work in livestock?
 
How effective is the vaccine?
 
How long is the delay between vaccination and immunity?
How many cattle do we have the capacity to vaccinate each day as part of an
emergency response?
 
What size of vaccination ring
should we use?
 
How do we determine the optimal ring with
uncertainty regarding efficacy, capacity and time
delay?
 
Don’t vaccinate
 
Vaccinate
 
Small rings?
 
“Maybe” vaccinate
 
Large rings?
What size of vaccination ring
should we use?
How do we determine the optimal ring with
uncertainty regarding efficacy, capacity and time
delay?
100%
0%
Vaccine Efficacy
50%
 
Should we vaccinate?
 
If so, what ring size should we use?
A Toy Example
 
Let’s assume we know the following:
 
Vaccine Efficacy is either 50%, 70% or 90%.
 
Time Delay to Immunity is either 2, 4 or 6 days.
 
Vaccine capacity is either 20K, 35K or 50K doses per day.
 
Policy Makers are considering 5 possible vaccination radii:
3km, 5km, 7km, 10km or 15km.
The Warwick Model
The Warwick Model
 
All parameters are estimated through fitting to 2001
UK epidemic data.
Results
 
Optimal strategy is independent of time delay to immunity.
Results
Average number of cattle culled (in millions) for vaccine efficacy of 90%, 6 day delay to immunity and 50000
doses per day.
Optimal strategy is independent of time delay to immunity.
Optimal vaccination radius highly dependent upon number of doses per day.
Uncertainty in Vaccine Capacity
 
If it is possible to know 
a priori 
how many doses are
available, the optimal strategy can be determined.
 
Optimal strategy varies depending upon your weight of belief in the three levels of
constraint.
 
Optimal strategy to minimise epidemic duration is independent of efficacy and time delay.
What are the savings that can be made by resolving the
uncertainty surrounding vaccination?
What are the savings that can be made by resolving the
uncertainty surrounding vaccination?
Looking at livestock culled:
If we resolved all uncertainty, we predict that 
221,900
 fewer livestock would need to
be culled.
What are the savings that can be made by resolving the
uncertainty surrounding vaccination?
Looking at livestock culled:
If we resolved all uncertainty, we predict that 
221,900
 fewer livestock would need to
be culled.
Knowing the true:
 
vaccine delay would give 
3%
 of this saving
 
What are the savings that can be made by resolving the
uncertainty surrounding vaccination?
Looking at livestock culled:
If we resolved all uncertainty, we predict that 
221,900
 fewer livestock would need to
be culled.
Knowing the true:
 
vaccine delay would give 
3%
 of this saving
 
vaccine efficacy would give 
7.3%
 of this saving
 
What are the savings that can be made by resolving the
uncertainty surrounding vaccination?
Looking at livestock culled:
If we resolved all uncertainty, we predict that 
221,900
 fewer livestock would need to
be culled.
Knowing the true:
 
vaccine delay would give 
3%
 of this saving
 
vaccine efficacy would give 
7.3%
 of this saving
 
vaccine capacity would give 
89.7%
 of this saving
Conclusions
There are potential savings to be made by resolving uncertainty regarding the
capacity for emergency vaccination before a FMD outbreak
Conclusions
There are potential savings to be made by resolving uncertainty regarding the
capacity for emergency vaccination before a FMD outbreak
Resolving uncertainty regarding the effectiveness of the vaccine appears to have
significantly less effect upon the optimal vaccination strategy
Conclusions
There are potential savings to be made by resolving uncertainty regarding the
capacity for emergency vaccination before a FMD outbreak
Resolving uncertainty regarding the effectiveness of the vaccine appears to have
significantly less effect upon the optimal vaccination strategy
This allows for informed decisions to be made about the best vaccination ring size
for outbreak control
Acknowledgements
Acknowledgements
Naomi Bradbury (Warwick)
Will Probert (Warwick)
Matt Ferrari (Penn State)
Kat Shea (Penn State)
Matt Keeling (Warwick)
Chris Fonnesbeck (Vanderbilt)
Mike Runge (USGS)
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Exploring the value of perfect information and the dynamics of information analysis during disease outbreaks, particularly focusing on emergency vaccination for Foot-and-Mouth Disease (FMD). Addressing uncertainties surrounding FMD control, vaccine effectiveness, capacity, and optimal vaccination strategies amid outbreaks. Insights into dealing with unpredictability when making disease control predictions.

  • Disease outbreaks
  • Emergency vaccination
  • Uncertainty management
  • FMD control
  • Information analysis

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  1. Quantifying the Value of Perfect Information in Emergency Vaccination Campaigns for FMD Bradbury, N.V., Probert, W.J.M., Shea, K., Runge, M.C., Fonnesbeck, C.J., Keeling, M.J., Ferrari, M.J. & Tildesley, M.J.* Open Session of the EuFMD - Cascais Portugal 26-28 October 2016

  2. Value of information (VOI) analysis During outbreaks research focuses on analysing the dynamics of that outbreak

  3. Value of information (VOI) analysis During outbreaks research focuses on analysing the dynamics of that outbreak Between outbreaks we can increase our knowledge so there is less uncertainty in future outbreaks

  4. Value of information (VOI) analysis During outbreaks research focuses on analysing the dynamics of that outbreak Between outbreaks we can increase our knowledge so there is less uncertainty in future outbreaks The use of emergency FMD vaccination as a control measure has been contentious, partly due to uncertainty

  5. So how do we deal with uncertainty when making predictions regarding control?

  6. Uncertainty surrounding emergency vaccination How does emergency vaccination work in livestock? How effective is the vaccine? How long is the delay between vaccination and immunity?

  7. Uncertainty surrounding emergency vaccination How does emergency vaccination work in livestock? How effective is the vaccine? How long is the delay between vaccination and immunity? How many cattle do we have the capacity to vaccinate each day as part of an emergency response?

  8. Vaccination Throughout the 2001 UK FMD epidemic we were continually asked about vaccination. What size of vaccination ring should we use? How do we determine the optimal ring with uncertainty regarding efficacy, capacity and time delay? IP Vaccine Efficacy 50% 100% 0% Vaccinate Don t vaccinate Maybe vaccinate Large rings? Small rings? OS16

  9. Vaccination Throughout the 2001 UK FMD epidemic we were continually asked about vaccination. What size of vaccination ring should we use? How do we determine the optimal ring with uncertainty regarding efficacy, capacity and time delay? IP Vaccine Efficacy 50% 100% 0% Should we vaccinate? If so, what ring size should we use? OS16

  10. A Toy Example Let s assume we know the following: Vaccine Efficacy is either 50%, 70% or 90%. Time Delay to Immunity is either 2, 4 or 6 days. Vaccine capacity is either 20K, 35K or 50K doses per day. Policy Makers are considering 5 possible vaccination radii: 3km, 5km, 7km, 10km or 15km.

  11. The Warwick Model Probability of infection per day for every susceptible farm is given by: [ i ] ps][TcNc,j qc + TsNs,jqs]K(dij) Prob = 1 - exp - [ScNc,i pc+ SsNs,i Infected j Sc/s N i - susceptibility of cattle/sheep. - number of cattle/sheep on farm i. - Transmission rate of cattle/sheep. c/s Tc,s - The transmission kernel. A parameter which weights the probability of infection based on the distance between farm i and farm j. K(dij) All parameters are estimated through fitting to 2001 UK epidemic data. Transmission Risk Kernel Distance from source

  12. Results Average number of cattle culled (in millions) for vaccine efficacy of 90%, 6 day delay to immunity and 50000 doses per day. Optimal strategy is independent of time delay to immunity.

  13. Results Average number of cattle culled (in millions) for vaccine efficacy of 90%, 6 day delay to immunity and 50000 doses per day. Optimal strategy is independent of time delay to immunity. Optimal vaccination radius highly dependent upon number of doses per day.

  14. Uncertainty in Vaccine Capacity If it is possible to know a priori how many doses are available, the optimal strategy can be determined. 100% sure that 20,000 doses are available 5km vaccination optimal. 100% sure that 50,000 doses are available 15km vaccination optimal. Optimal strategy varies depending upon your weight of belief in the three levels of constraint. OS16

  15. OS16

  16. Optimal strategy to minimise epidemic duration is independent of efficacy and time delay. OS16

  17. What are the savings that can be made by resolving the uncertainty surrounding vaccination?

  18. What are the savings that can be made by resolving the uncertainty surrounding vaccination? Looking at livestock culled: If we resolved all uncertainty, we predict that 221,900 fewer livestock would need to be culled.

  19. What are the savings that can be made by resolving the uncertainty surrounding vaccination? Looking at livestock culled: If we resolved all uncertainty, we predict that 221,900 fewer livestock would need to be culled. Knowing the true: vaccine delay would give 3% of this saving

  20. What are the savings that can be made by resolving the uncertainty surrounding vaccination? Looking at livestock culled: If we resolved all uncertainty, we predict that 221,900 fewer livestock would need to be culled. Knowing the true: vaccine delay would give 3% of this saving vaccine efficacy would give 7.3% of this saving

  21. What are the savings that can be made by resolving the uncertainty surrounding vaccination? Looking at livestock culled: If we resolved all uncertainty, we predict that 221,900 fewer livestock would need to be culled. Knowing the true: vaccine delay would give 3% of this saving vaccine efficacy would give 7.3% of this saving vaccine capacity would give 89.7% of this saving

  22. Conclusions There are potential savings to be made by resolving uncertainty regarding the capacity for emergency vaccination before a FMD outbreak

  23. Conclusions There are potential savings to be made by resolving uncertainty regarding the capacity for emergency vaccination before a FMD outbreak Resolving uncertainty regarding the effectiveness of the vaccine appears to have significantly less effect upon the optimal vaccination strategy

  24. Conclusions There are potential savings to be made by resolving uncertainty regarding the capacity for emergency vaccination before a FMD outbreak Resolving uncertainty regarding the effectiveness of the vaccine appears to have significantly less effect upon the optimal vaccination strategy This allows for informed decisions to be made about the best vaccination ring size for outbreak control

  25. Acknowledgements Naomi Bradbury (Warwick) Will Probert (Warwick) Matt Ferrari (Penn State) Kat Shea (Penn State) Matt Keeling (Warwick) Chris Fonnesbeck (Vanderbilt) Mike Runge (USGS)

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