Epidemiological impact of prioritising SARS-CoV-2 vaccination by antibody status: mathematical modelling analyses
Epidemiological impact of prioritising SARS-CoV-2 vaccination by antibody status: mathematical modelling analyses
复制标题
DOI：
10.1136/bmjinnov-2021-000677
复制
发表时间：
2021-04-01
期刊：
影响因子：
2
通讯作者：
Abu-Raddad, Laith J.
中科院分区：
文献类型：
--
作者：
Ayoub, Houssein H.;Chemaitelly, Hiam;Abu-Raddad, Laith J.
背景：针对SARS-CoV-2的疫苗已被开发出来，但它们的可用性远远不能满足全球需求。本研究以卡塔尔为例，探讨了根据受者抗体状况(即暴露状况)优先接种疫苗的影响。方法采用描述SARS-CoV-2传播和疾病进展的确定性元人口数学模型，在不同的放大场景下评估疫苗接种的影响(定义为减少感染发生率和为避免一次感染或一种不良疾病结局所需的疫苗接种数)。结果对于一种预防感染有效率为95%的疫苗，通过优先接种抗体阴性的人来避免一次感染、疾病结局或死亡所需的疫苗数量的一半。根据抗体状态进行优先排序，可以更快地减少发病率，并导致更快地消除感染和恢复正常。进一步按年龄组进行优先排序扩大了按抗体状态优先排序的收益。在开始接种疫苗时已经感染的人口比例为30%-60%的情况下，根据抗体状况进行优先排序的收益最大。对于只预防疾病而不预防感染的疫苗，疫苗的影响降低了一半，无论这种影响是从避免感染或疾病结果的角度衡量的，但使用抗体状况优先接种疫苗的相对收益是相似的。结论在疫苗剂量仍然短缺的情况下，优先接种抗体阴性的人可以更快地实现重大健康和经济收益。
Background Vaccines against SARS-CoV-2 have been developed, but their availability falls far short of global needs. This study aimed to investigate the impact of prioritising available doses on the basis of recipient antibody status, that is by exposure status, using Qatar as an example.Methods Vaccination impact (defined as the reduction in infection incidence and the number of vaccinations needed to avert one infection or one adverse disease outcome) was assessed under different scale-up scenarios using a deterministic meta-population mathematical model describing SARS-CoV-2 transmission and disease progression in the presence of vaccination.Results For a vaccine that protects against infection with an efficacy of 95%, half as many vaccinations were needed to avert one infection, disease outcome or death by prioritising antibody-negative individuals for vaccination. Prioritisation by antibody status reduced incidence at a faster rate and led to faster elimination of infection and return to normalcy. Further prioritisation by age group amplified the gains of prioritisation by antibody status. Gains from prioritisation by antibody status were largest in settings where the proportion of the population already infected at the commencement of vaccination was 30%-60%. For a vaccine that only protects against disease and not infection, vaccine impact was reduced by half, whether this impact was measured in terms of averted infections or disease outcomes, but the relative gains from using antibody status to prioritise vaccination recipients were similar.Conclusions Major health and economic gains can be achieved more quickly by prioritizing those who are antibody-negative while doses of the vaccine remain in short supply.