{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:28:39Z","timestamp":1791959319484,"version":"4.3.4"},"reference-count":29,"publisher":"National Academy of Sciences","issue":"42","content-domain":{"domain":["www.pnas.org"],"crossmark-restriction":true},"short-container-title":["Proc. Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2006,10,17]]},"abstract":"<jats:p>Concerns over bioterrorism and emerging diseases have led to the widespread use of epidemic models for evaluating public health strategies. Partly because epidemic models often capture the dynamics of prior epidemics remarkably well, little attention has been paid to how uncertainty in parameter estimates might affect model predictions. To understand such effects, we used Bayesian statistics to rigorously estimate the uncertainty in the parameters of an epidemic model, focusing on smallpox bioterrorism. We then used a vaccination model to translate the uncertainty in the model parameters into uncertainty in which of two vaccination strategies would provide a better response to bioterrorism, mass vaccination, or vaccination of social contacts, so-called \u201ctrace vaccination.\u201d Our results show that the uncertainty in the model parameters is remarkably high and that this uncertainty has important implications for vaccination strategies. For example, under one plausible scenario, the most likely outcome is that mass vaccination would save \u2248100,000 more lives than trace vaccination. Because of the high uncertainty in the parameters, however, there is also a substantial probability that mass vaccination would save 200,000 or more lives than trace vaccination. In addition to providing the best response to the most likely outcome, mass vaccination thus has the advantage of preventing outcomes that are only slightly less likely but that are substantially more horrific. Rigorous estimates of uncertainty thus can reveal hidden advantages of public health strategies, suggesting that formal uncertainty estimation should play a key role in planning for epidemics.<\/jats:p>","DOI":"10.1073\/pnas.0600816103","type":"journal-article","created":{"date-parts":[[2006,10,9]],"date-time":"2006-10-09T21:02:33Z","timestamp":1160427753000},"page":"15693-15697","update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":87,"title":["Uncertainty in predictions of disease spread and public health responses to bioterrorism and emerging diseases"],"prefix":"10.1073","volume":"103","author":[{"given":"Bret D.","family":"Elderd","sequence":"first","affiliation":[{"name":"*Center for Integrating Statistical and Environmental Science, University of Chicago, 5734 South Ellis Avenue, Chicago, IL 60637;"},{"name":"Department of Ecology and Evolution, University of Chicago, 1101 East 57th Street, Chicago, IL 60637"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanja M.","family":"Dukic","sequence":"additional","affiliation":[{"name":"Department of Health Studies, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Dwyer","sequence":"additional","affiliation":[{"name":"Department of Ecology and Evolution, University of Chicago, 1101 East 57th Street, Chicago, IL 60637"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2006,10,17]]},"reference":[{"key":"e_1_3_4_1_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature02007"},{"key":"e_1_3_4_2_2","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198545996.001.0001","volume-title":"Infectious Diseases of Humans: Dynamics and Control","author":"Anderson RM","year":"1991","unstructured":"RM Anderson, RM May Infectious Diseases of Humans: Dynamics and Control (Oxford Univ Press, Oxford, 1991)."},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/414748a"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa025075"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1074674"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature02541"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1086478"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature01343"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature03063"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/339467"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.162282799"},{"key":"e_1_3_4_12_2","volume-title":"Smallpox Response Plan and Guidelines","year":"2002","unstructured":"Smallpox Response Plan and Guidelines (Centers Dis Control, AtlantaTechnical Report Draft 3.0. 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