A previously developed mathematical model of pandemic influenza [12] was adapted, which simulates differing pandemic scenarios, here constrained to 3 scenarios: (1) low transmissibility/high severity, (2) moderate transmissibility/moderate severity and (3) high transmissibility/high severity. We assumed vaccine delivery six weeks into the local epidemic, with sensitivity analyses of zero and twelve weeks. To compare proposed vaccine allocation strategies additional population strata and vaccine administration were included in the model framework. Model outputs captured outcomes of public health importance for each group including clinical attack rate, hospitalisations, intensive care unit (ICU) admissions and deaths in hospital. A full description of model structure and assumptions is in the Supplementary Material .

Broadly, the model considered two dimensions of strategic vaccine use:

Comparison of a direct protection strategy focused on preventing severe outcomes by targeting ‘at risk’ groups, with an indirect protection strategy aimed at reducing transmission by vaccinating school children;

For scenarios where two vaccine doses are required for optimal protection, comparison of the impact of a two dose (complete) schedule, with that of a single dose administered to twice as many individuals.

Vaccine strategies were considered in isolation to assess their likely contribution to reducing infection and disease burden, without confounding due to the influence of other public health measures that may be differentially applied to population subgroups.

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