建構動態疫苗分配模型以預防季節性流感流行

Dynamic decision models of vaccine distribution for preventing seasonal influenza outbreaks

吳宇軒(Yu-Hsuan Wu)

指導教授 ： 陳勝一

國立交通大學/管理學院/工業工程與管理系所/碩士(2018年)

摘要

流感是一種很常見的流行性疾病，由於其爆發流行快速、散播範圍廣泛以及併發症嚴重，因此威力不容小覷，也因而每年流感的爆發都會對世界各地的公共健康造成威脅。接種流感疫苗是預防流感最有效的策略；然而，在台灣地區，公費流感疫苗計畫雖行之有年，但目前的計畫實施中仍然存在著許多尚未解決的問題，而流感的動態性與不規則的流行模式更反映了疫苗接種計畫決策的難度與複雜度。本研究的目的就是希望能套用最佳化的概念，開發一套動態決策的方法來解決這些重要問題，以期能改善台灣現有的公費流感疫苗政策。所謂的動態決策是指，我們以一年的時間軸為限，以週別將時間劃分成多個決策階段，在每一期決策階段裡，我們開發並結合了流行病倉室模型以及疫苗分配模型。此外，針對接種人群對於疫苗的需求，我們還另外開發了一個疫苗需求模型來估計每一週會去施打疫苗的人數。由於我們想針對現有的疫苗分配政策做改善，因此我們將台灣的人口依據年齡與縣市劃分成不同的族群，並透過這樣的動態模型去求得疫苗最佳施打量。透過動態的連結，以及這三種模型的相互支援，我們能夠去捕捉流感的動態性以及許多的不確定性因素，並進一步分析不同的疫苗接種政策。

關鍵字

季節性流感 ； 倉室模型 ； 疫苗分配 ； 動態決策模型

並列摘要

Influenza is a common infectious disease. Because of its rapid outbreak and serious complications, influenza poses a threat to public health around the world in each year. Vaccination is the most effective strategy for preventing influenza; however, in Taiwan, the public-funded vaccination program lasts for years, but there are still many unresolved issues in the implementation of this program. Influenza's dynamic and irregular epidemic patterns reflect the difficulty and complexity of vaccination plan decision-making. Therefore, determining the optimal vaccination policy based on these uncertainties is a challenging issue and a good research opportunity. The purpose of this study is to develop a dynamic decision framework to solve these problems and improve Taiwan's public-funded vaccination program. The dynamic decision framework means that we divide a whole year into multiple decision-making phases by week, and the decision-making in each phase can be regarded as a sub-problem of our research. At each phase, we develop and combine the compartmental model and the vaccine distribution model. In addition, we develop a vaccine demand model to estimate the number of people who will be vaccinated in every week. Since we want to make improvements to the existing policy, we divide the population of Taiwan into different spatial and age groups. Through the dynamic linking of these three models, we can capture the dynamics of the influenza and further analyze different vaccination policies.

並列關鍵字

Seasonal influenza ； Compartmental model ； Vaccine distribution ； Dynamic decision model ； Mixed-integer programming

參考文獻

參考文獻

[1] 行政院衛生福利部疾病管制署(2017)‧流感併發重症─認識疾病‧取自

https://www.cdc.gov.tw/professional/submenu.aspx?treeid=8208eb95dda7842a&nowtreeid=31b3b7bf7e15ed33

[2] World Health Organization. Media centre. (2018). Influenza (Seasonal). Retrieved March 7, 2018, from http://www.who.int/mediacentre/factsheets/fs211/en/

[3] 政府資料開放平台(2017)‧健保門診及住院就診人次統計─類流感‧取自