Pandemic simulation of antivirals + school closures: buying time until strain-specific vaccine is available

A strain-specific vaccine is unlikely to be available in the early phases of a potential H5N1 avian influenza pandemic. It could be months and at the current production rate may not provide timely protection to the population. Intervention strategies that control the spread of infection will be necessary in this situation, such as the use of the US stockpile of antiviral medication coupled with a 6-month school closure. The agent-based simulation model, EpiSimS, was used to assess the impact of this intervention strategy followed by three different vaccine approaches: (1) 2-dose, 80% effective, (2) 1-dose, 30% effective, and (3) 1 dose, 80% effective. Simulations show that the combination of antivirals, school closures, and a strain-specific vaccine can reduce morbidity and mortality while in effect. A significant second infection wave can occur with current vaccine technology once school closures are relaxed, though an ideal vaccine is able to contain it. In our simulations, worker absenteeism increases in all cases mostly attributed to household adults staying home with children due to the school closures.