Within-country age-based prioritisation, global allocation, and public health impact of a vaccine against SARS-CoV-2: A mathematical modelling analysis.
Within-country age-based prioritisation, global allocation, and public health impact of a vaccine against SARS-CoV-2: A mathematical modelling analysis.
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SARS-CoV-2疫苗的国家内基于年龄的优先顺序，全球分配和公共卫生影响：数学建模分析。
DOI：
10.1016/j.vaccine.2021.04.002
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发表时间：
2021-05-21
期刊：
影响因子：
5.5
通讯作者：
Ghani AC
中科院分区：
文献类型：
--
作者：
Hogan AB;Winskill P;Watson OJ;Walker PGT;Whittaker C;Baguelin M;Brazeau NF;Charles GD;Gaythorpe KAM;Hamlet A;Knock E;Laydon DJ;Lees JA;Løchen A;Verity R;Whittles LK;Muhib F;Hauck K;Ferguson NM;Ghani AC
2021年全球COVID-19疫苗的剂量供应将受到限制。在一个国家内，优先考虑剂量以保护那些死亡风险最高的人是有效的。对于2021年20亿剂的供应，根据人口规模分配给各国是有效和公平的。全球致力于开发安全有效的COVID-19疫苗的努力非同寻常，目前许多国家正在进行疫苗接种。然而，2021年可用的剂量可能有限。我们扩展了SARS-CoV-2在不同国家环境中传播的数学模型，以评估使用世卫组织开发的目标产品特征的潜在疫苗对公共卫生的影响。我们确定了最佳的疫苗分配策略内和国家之间，以最大限度地避免剂量供应的限制下的死亡。我们发现，SARS-CoV-2疫苗接种对健康的影响取决于疫苗接种开始时的累积人群感染率、自然免疫的持续时间、疫苗接种前的流行轨迹以及有效治疗疾病的医疗水平。在一个国家内，我们发现，对于有限的供应（剂量为< 20%的人口），最佳策略是针对老年人。然而，在供应量增加的情况下，如果在维持其他干预措施的同时可以进行疫苗接种，最佳战略就转向针对关键传播者，以间接保护弱势群体。随着供应的增加，减少或阻断感染的疫苗比单纯预防疾病的疫苗产生更大的影响，因为它们为高危人群提供了间接保护。考虑到2021年全球剂量供应量为20亿，我们发现，按照人口规模按比例向各国分配剂量的战略在避免死亡方面接近最佳，并且符合大流行病防备规划中商定的伦理原则。
The global dose supply of COVID-19 vaccines will be constrained in 2021. Within a country, prioritising doses to protect those at highest mortality risk is efficient. For a 2 billion dose supply in 2021, allocating to countries according to population size is efficient and equitable. The worldwide endeavour to develop safe and effective COVID-19 vaccines has been extraordinary, and vaccination is now underway in many countries. However, the doses available in 2021 are likely to be limited. We extend a mathematical model of SARS-CoV-2 transmission across different country settings to evaluate the public health impact of potential vaccines using WHO-developed target product profiles. We identify optimal vaccine allocation strategies within- and between-countries to maximise averted deaths under constraints on dose supply. We find that the health impact of SARS-CoV-2 vaccination depends on the cumulative population-level infection incidence when vaccination begins, the duration of natural immunity, the trajectory of the epidemic prior to vaccination, and the level of healthcare available to effectively treat those with disease. Within a country we find that for a limited supply (doses for < 20% of the population) the optimal strategy is to target the elderly. However, with a larger supply, if vaccination can occur while other interventions are maintained, the optimal strategy switches to targeting key transmitters to indirectly protect the vulnerable. As supply increases, vaccines that reduce or block infection have a greater impact than those that prevent disease alone due to the indirect protection provided to high-risk groups. Given a 2 billion global dose supply in 2021, we find that a strategy in which doses are allocated to countries proportional to population size is close to optimal in averting deaths and aligns with the ethical principles agreed in pandemic preparedness planning.
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DOI：
10.1126/science.abe2803
发表时间：
2020-09-11
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Emanuel EJ;Persad G;Kern A;Buchanan A;Fabre C;Halliday D;Heath J;Herzog L;Leland RJ;Lemango ET;Luna F;McCoy MS;Norheim OF;Ottersen T;Schaefer GO;Tan KC;Wellman CH;Wolff J;Richardson HS
通讯作者：
Richardson HS
影响因子：
56.9
作者：
Britton, Tom;Ball, Frank;Trapman, Pieter
通讯作者：
Trapman, Pieter
DOI：
10.1056/nejmoa2035389
发表时间：
2021-02-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Baden LR;El Sahly HM;Essink B;Kotloff K;Frey S;Novak R;Diemert D;Spector SA;Rouphael N;Creech CB;McGettigan J;Khetan S;Segall N;Solis J;Brosz A;Fierro C;Schwartz H;Neuzil K;Corey L;Gilbert P;Janes H;Follmann D;Marovich M;Mascola J;Polakowski L;Ledgerwood J;Graham BS;Bennett H;Pajon R;Knightly C;Leav B;Deng W;Zhou H;Han S;Ivarsson M;Miller J;Zaks T;COVE Study Group
通讯作者：
COVE Study Group
DOI：
10.1126/science.abe6959
发表时间：
2021-02-26
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Bubar KM;Reinholt K;Kissler SM;Lipsitch M;Cobey S;Grad YH;Larremore DB
通讯作者：
Larremore DB
在不断变化的社会和流行病学格局中优先考虑 COVID-19 疫苗接种：数学模型研究。
DOI：
10.1016/s1473-3099(21)00057-8
发表时间：
2021-08
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Jentsch PC;Anand M;Bauch CT
通讯作者：
Bauch CT