Vaccine optimization for COVID-19: Who to vaccinate first?
Vaccine optimization for COVID-19: Who to vaccinate first?
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Covid-19的疫苗优化：谁先接种疫苗？
DOI：
10.1126/sciadv.abf1374
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发表时间：
2020-02
期刊：
影响因子：
13.6
通讯作者：
Brown ER
中科院分区：
文献类型：
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作者：
Matrajt L;Eaton J;Leung T;Brown ER
COVID-19疫苗的最佳使用主要取决于疫苗的有效性和可用剂量。疫苗（如有）将可能成为我们控制COVID-19疫情的最佳工具。即使在最乐观的情况下，疫苗短缺也可能发生。使用年龄分层数学模型与优化算法配对，我们确定了许多情况下四种不同指标（死亡，症状性感染，最大非ICU和ICU住院）的最佳疫苗分配。我们发现，如果有很高比例的人群接种了最佳疫苗，那么有效性≥50%的疫苗足以大幅缓解正在发生的大流行。当最大限度地减少死亡时，我们发现，对于低疫苗有效性，无论疫苗接种覆盖率如何，最好首先将疫苗分配给高风险（年龄较大）年龄组。相比之下，为了提高疫苗的有效性，有一种转变，即首先将疫苗分配给高传播（年轻）年龄组，以提高疫苗接种覆盖率。虽然还有其他社会和伦理方面的考虑，但这项工作可以为疫苗的优先顺序提供基于证据的理由。
The optimal use of COVID-19 vaccine depends mainly on how efficacious the vaccine is and how many doses are available. Vaccines, when available, will likely become our best tool to control the COVID-19 pandemic. Even in the most optimistic scenarios, vaccine shortages will likely occur. Using an age-stratified mathematical model paired with optimization algorithms, we determined optimal vaccine allocation for four different metrics (deaths, symptomatic infections, and maximum non-ICU and ICU hospitalizations) under many scenarios. We find that a vaccine with effectiveness ≥50% would be enough to substantially mitigate the ongoing pandemic, provided that a high percentage of the population is optimally vaccinated. When minimizing deaths, we find that for low vaccine effectiveness, irrespective of vaccination coverage, it is optimal to allocate vaccine to high-risk (older) age groups first. In contrast, for higher vaccine effectiveness, there is a switch to allocate vaccine to high-transmission (younger) age groups first for high vaccination coverage. While there are other societal and ethical considerations, this work can provide an evidence-based rationale for vaccine prioritization.