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Optimal SARS-CoV-2 vaccine allocation using real-time attack-rate estimates in Rhode Island and Massachusetts.
BMC Med. 2021 07 13; 19(1):162.BM

Abstract

BACKGROUND

When three SARS-CoV-2 vaccines came to market in Europe and North America in the winter of 2020-2021, distribution networks were in a race against a major epidemiological wave of SARS-CoV-2 that began in autumn 2020. Rapid and optimized vaccine allocation was critical during this time. With 95% efficacy reported for two of the vaccines, near-term public health needs likely require that distribution is prioritized to the elderly, health care workers, teachers, essential workers, and individuals with comorbidities putting them at risk of severe clinical progression.

METHODS

We evaluate various age-based vaccine distributions using a validated mathematical model based on current epidemic trends in Rhode Island and Massachusetts. We allow for varying waning efficacy of vaccine-induced immunity, as this has not yet been measured. We account for the fact that known COVID-positive cases may not have been included in the first round of vaccination. And, we account for age-specific immune patterns in both states at the time of the start of the vaccination program. Our analysis assumes that health systems during winter 2020-2021 had equal staffing and capacity to previous phases of the SARS-CoV-2 epidemic; we do not consider the effects of understaffed hospitals or unvaccinated medical staff.

RESULTS

We find that allocating a substantial proportion (>75%) of vaccine supply to individuals over the age of 70 is optimal in terms of reducing total cumulative deaths through mid-2021. This result is robust to different profiles of waning vaccine efficacy and several different assumptions on age mixing during and after lockdown periods. As we do not explicitly model other high-mortality groups, our results on vaccine allocation apply to all groups at high risk of mortality if infected. A median of 327 to 340 deaths can be avoided in Rhode Island (3444 to 3647 in Massachusetts) by optimizing vaccine allocation and vaccinating the elderly first. The vaccination campaigns are expected to save a median of 639 to 664 lives in Rhode Island and 6278 to 6618 lives in Massachusetts in the first half of 2021 when compared to a scenario with no vaccine. A policy of vaccinating only seronegative individuals avoids redundancy in vaccine use on individuals that may already be immune, and would result in 0.5% to 1% reductions in cumulative hospitalizations and deaths by mid-2021.

CONCLUSIONS

Assuming high vaccination coverage (>28%) and no major changes in distancing, masking, gathering size, hygiene guidelines, and virus transmissibility between 1 January 2021 and 1 July 2021 a combination of vaccination and population immunity may lead to low or near-zero transmission levels by the second quarter of 2021.

Authors+Show Affiliations

Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA. tnt9@psu.edu.Center for Infectious Disease Dynamics, Department of Statistics, Pennsylvania State University, University Park, PA, USA.Department of Physics, Pennsylvania State University, University Park, PA, USA.Center for Infectious Disease Dynamics, Department of Bioengineering, Pennsylvania State University, University Park, PA, USA.Center for Infectious Disease Dynamics, Department of Statistics, Pennsylvania State University, University Park, PA, USA.Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.Center for Infectious Disease Dynamics, Department of Bioengineering, Pennsylvania State University, University Park, PA, USA.Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA.Yale School of Medicine, Yale University, New Haven, CT, USA.Center for Infectious Disease Dynamics, Department of Bioengineering, Pennsylvania State University, University Park, PA, USA.Department of Medicine, Brown University, Providence, RI, USA.Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.Center for Infectious Disease Dynamics, Department of Statistics, Pennsylvania State University, University Park, PA, USA.Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

34253200

Citation

Tran, Thu Nguyen-Anh, et al. "Optimal SARS-CoV-2 Vaccine Allocation Using Real-time Attack-rate Estimates in Rhode Island and Massachusetts." BMC Medicine, vol. 19, no. 1, 2021, p. 162.
Tran TN, Wikle NB, Albert E, et al. Optimal SARS-CoV-2 vaccine allocation using real-time attack-rate estimates in Rhode Island and Massachusetts. BMC Med. 2021;19(1):162.
Tran, T. N., Wikle, N. B., Albert, E., Inam, H., Strong, E., Brinda, K., Leighow, S. M., Yang, F., Hossain, S., Pritchard, J. R., Chan, P., Hanage, W. P., Hanks, E. M., & Boni, M. F. (2021). Optimal SARS-CoV-2 vaccine allocation using real-time attack-rate estimates in Rhode Island and Massachusetts. BMC Medicine, 19(1), 162. https://doi.org/10.1186/s12916-021-02038-w
Tran TN, et al. Optimal SARS-CoV-2 Vaccine Allocation Using Real-time Attack-rate Estimates in Rhode Island and Massachusetts. BMC Med. 2021 07 13;19(1):162. PubMed PMID: 34253200.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optimal SARS-CoV-2 vaccine allocation using real-time attack-rate estimates in Rhode Island and Massachusetts. AU - Tran,Thu Nguyen-Anh, AU - Wikle,Nathan B, AU - Albert,Emmy, AU - Inam,Haider, AU - Strong,Emily, AU - Brinda,Karel, AU - Leighow,Scott M, AU - Yang,Fuhan, AU - Hossain,Sajid, AU - Pritchard,Justin R, AU - Chan,Philip, AU - Hanage,William P, AU - Hanks,Ephraim M, AU - Boni,Maciej F, Y1 - 2021/07/13/ PY - 2021/01/20/received PY - 2021/06/16/accepted PY - 2021/7/13/entrez PY - 2021/7/14/pubmed PY - 2021/7/22/medline KW - Mathematical modeling KW - Optimal vaccine allocation KW - Real-time seroprevalence KW - SARS-CoV-2 KW - Vaccination SP - 162 EP - 162 JF - BMC medicine JO - BMC Med VL - 19 IS - 1 N2 - BACKGROUND: When three SARS-CoV-2 vaccines came to market in Europe and North America in the winter of 2020-2021, distribution networks were in a race against a major epidemiological wave of SARS-CoV-2 that began in autumn 2020. Rapid and optimized vaccine allocation was critical during this time. With 95% efficacy reported for two of the vaccines, near-term public health needs likely require that distribution is prioritized to the elderly, health care workers, teachers, essential workers, and individuals with comorbidities putting them at risk of severe clinical progression. METHODS: We evaluate various age-based vaccine distributions using a validated mathematical model based on current epidemic trends in Rhode Island and Massachusetts. We allow for varying waning efficacy of vaccine-induced immunity, as this has not yet been measured. We account for the fact that known COVID-positive cases may not have been included in the first round of vaccination. And, we account for age-specific immune patterns in both states at the time of the start of the vaccination program. Our analysis assumes that health systems during winter 2020-2021 had equal staffing and capacity to previous phases of the SARS-CoV-2 epidemic; we do not consider the effects of understaffed hospitals or unvaccinated medical staff. RESULTS: We find that allocating a substantial proportion (>75%) of vaccine supply to individuals over the age of 70 is optimal in terms of reducing total cumulative deaths through mid-2021. This result is robust to different profiles of waning vaccine efficacy and several different assumptions on age mixing during and after lockdown periods. As we do not explicitly model other high-mortality groups, our results on vaccine allocation apply to all groups at high risk of mortality if infected. A median of 327 to 340 deaths can be avoided in Rhode Island (3444 to 3647 in Massachusetts) by optimizing vaccine allocation and vaccinating the elderly first. The vaccination campaigns are expected to save a median of 639 to 664 lives in Rhode Island and 6278 to 6618 lives in Massachusetts in the first half of 2021 when compared to a scenario with no vaccine. A policy of vaccinating only seronegative individuals avoids redundancy in vaccine use on individuals that may already be immune, and would result in 0.5% to 1% reductions in cumulative hospitalizations and deaths by mid-2021. CONCLUSIONS: Assuming high vaccination coverage (>28%) and no major changes in distancing, masking, gathering size, hygiene guidelines, and virus transmissibility between 1 January 2021 and 1 July 2021 a combination of vaccination and population immunity may lead to low or near-zero transmission levels by the second quarter of 2021. SN - 1741-7015 UR - https://www.unboundmedicine.com/medline/citation/34253200/Optimal_SARS_CoV_2_vaccine_allocation_using_real_time_attack_rate_estimates_in_Rhode_Island_and_Massachusetts_ L2 - https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02038-w DB - PRIME DP - Unbound Medicine ER -