Optimal SARS-CoV-2 vaccine allocation using real-time seroprevalence estimates in Rhode Island and Massachusetts.
Optimal SARS-CoV-2 vaccine allocation using real-time seroprevalence estimates in Rhode Island and Massachusetts.
复制标题
使用罗德岛州和马萨诸塞州的实时血清流行率估计来优化 SARS-CoV-2 疫苗分配。
DOI：
10.1101/2021.01.12.21249694
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Boni,MaciejF
中科院分区：
文献类型：
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作者：
Tran,ThuNguyen-Anh;Wikle,Nathan;Albert,Joseph;Inam,Haider;Strong,Emily;Brinda,Karel;Leighow,ScottM;Yang,Fuhan;Hossain,Sajid;Pritchard,JustinR;Chan,Philip;Hanage,WilliamP;Hanks,EphraimM;Boni,MaciejF
随着三种SARS-CoV-2疫苗于2020-2021年冬季在欧洲和北美上市，分销网络将与2020年秋季开始的SARS-CoV-2流行病学大浪潮展开竞争。在此期间，快速和优化的疫苗分配至关重要。据报道，其中两种疫苗的有效性为95%，近期的公共卫生需求要求优先向老年人、卫生保健工作者、教师、基本工作者和患有使他们面临严重临床进展风险的合并症的个人分发。在这里，我们评估各种基于年龄的疫苗分布使用一个有效的数学模型，根据当前的流行趋势在罗得岛和马萨诸塞州。我们考虑到疫苗诱导的免疫效力的不同减弱，因为这还没有被测量。我们解释了已知的COVID阳性病例可能不包括在第一轮疫苗接种中的事实。而且，我们解释了这两个州目前的年龄特异性免疫模式。我们发现，将疫苗供应的很大一部分（> 75%）分配给70岁以上的个人，对于减少到2021年年中的总累计死亡人数来说是最佳的。由于我们没有明确模拟其他高死亡率群体，因此疫苗分配的这一结果适用于所有感染后死亡率高风险的群体。我们的分析证实，对于一种容易传播的呼吸道病毒，将大部分疫苗接种分配给死亡风险最高的群体是最佳的。我们的分析假设，2020-2021年冬季的卫生系统拥有与SARS-CoV-2疫情前几个阶段相同的人员配置和能力;我们没有考虑人手不足的医院或未接种疫苗的医务人员的影响。仅为血清阴性个体接种疫苗，可以避免对可能已经具有免疫力的个体重复使用疫苗，并将导致到2021年中期累计住院人数和死亡人数减少1%至2%。假设从现在到2021年春季，疫苗接种覆盖率很高（> 28%），并且在距离、掩蔽、聚集规模或卫生指南方面没有重大放松，我们的模型预测，疫苗接种和人群免疫力的结合将导致到2021年第二季度的低或接近零的传播水平。
As three SARS-CoV-2 vaccines come to market in Europe and North America in the winter of 2020–2021, distribution networks will be in a race against a major epidemiological wave of SARS-CoV-2 that began in autumn 2020. Rapid and optimized vaccine allocation is critical during this time. With 95% efficacy reported for two of the vaccines, near-term public health needs require that distribution is prioritized to the elderly, health-care workers, teachers, essential workers, and individuals with co-morbidities putting them at risk of severe clinical progression. Here, 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 be included in the first round of vaccination. And, we account for current age-specific immune patterns in both states. 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. As we do not explicitly model other high mortality groups, this result on vaccine allocation applies to all groups at high risk of mortality if infected. Our analysis confirms that for an easily transmissible respiratory virus, allocating a large majority of vaccinations to groups with the highest mortality risk is optimal. Our analysis assumes that health systems during winter 2020–2021 have 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. Vaccinating only seronegative individuals avoids redundancy in vaccine use on individuals that may already be immune, and will result in 1% to 2% reductions in cumulative hospitalizations and deaths by mid-2021. Assuming high vaccination coverage (> 28%) and no major relaxations in distancing, masking, gathering size, or hygiene guidelines between now and spring 2021, our model predicts that a combination of vaccination and population immunity will lead to low or near-zero transmission levels by the second quarter of 2021.