Optimal influenza vaccine distribution with equity

This paper is concerned with the optimal influenza vaccine distribution in a heterogeneous population consisting of multiple subgroups. We employ a compartmental model for influenza transmission and formulate a mathematical program to minimize the number of vaccine doses distributed to effectively extinguish an emerging outbreak in its early stages. We propose an equity constraint to help public health authorities consider fairness when making vaccine distribution decisions. We develop an exact solution approach that generates a vaccine distribution policy with a solution quality guarantee. We perform sensitivity analyses on key epidemic parameters in order to illustrate the application of the proposed model. We then analyze the scalability of the solution approach for a population consisting of subgroups based on geographic location and age. We finally demonstrate the proposed model's ability to consider vaccine coverage inequity and discuss a derivative-free optimization approach, as an alternative solution method which can consider various different objective functions and constraints. Our results indicate that consideration of group-specific transmission dynamics is paramount to the optimal distribution of influenza vaccines. (C) 2019 Elsevier B.V. All rights reserved.