Evaluating the Target-Population Recommendations for Influenza Vaccination: Evidence and Ethics

The influenza virus infects between 5 and 10 percent of the population each year, resulting in acute respiratory illness ranging from subclinical to severe; during a pandemic, 50 percent of the population can easily be infected. Influenza infection creates serious social, economic, and public health impacts; vaccination is the safest and most effective way to prevent infection and diminish these impacts. While seemingly straightforward, the influenza vaccine manufacturing process is fragile. Vaccine supply may suddenly decrease due to manufacturing issues, or the supply can be nonexistent due to a pandemic requiring the production of a new vaccine. Vaccine scarcity, for either reason, requires the use of target-population recommendations to allocate the vaccine until stocks can be restored. Target-population recommendations reflect the groups at highest risk of developing severe illness and complications from infection with the influenza virus. This project evaluates the target-population recommendations for the influenza vaccine, proposes improvements to facilitate evidence-based policymaking, and determines the ethical framework guiding the recommendations. This project utilizes methods from the humanities the disciplines of history, ethics, philosophy, and law are used in conversation with the scientific review. The central finding of this project is that adapting the current methodology used to evaluate influenza research would lead to better recommendations and contribute to improved communication between key stakeholders.