Impact of vaccination strategy on model outcomes.

Percent reduction in attack rate, hospitalizations, ICU admissions, and total deaths, relative to no vaccination, under different vaccination strategies. The effectiveness of different strategies was evaluated assuming an epidemic peak in (A) November, 2009 or (B) January, 2010, with vaccination campaigns initiated on November 15, 2009. Results for October, 2009 and December, 2009 were similar to November, 2009 and January, 2010, respectively, and are not shown. The impact of vaccination coverage is also shown, with base case rates representing the lower bound of vaccine uptake in the Canadian population, compared to likely upper limits of vaccine uptake. The midpoint of the boxes represents the median percent reduction in the outcome of interest, with the upper and lower bounds representing the maximum and minimum reductions, respectively, under varying assumptions of pre-existing immunity in individuals aged ≥53 (i.e., 30%, 50%, or 70%). Details of the different vaccination strategies (AR, Outcome, High risk/AR, High risk/Outcome) are outlined in the Methods.