Global impact of the first year of COVID-19 vaccination: a mathematical modelling study.
Global impact of the first year of COVID-19 vaccination: a mathematical modelling study.
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DOI：
10.1016/s1473-3099(22)00320-6
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发表时间：
2022-09
影响因子：
56.3
通讯作者：
Ghani, Azra C
中科院分区：
文献类型：
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作者：
Watson, Oliver J;Barnsley, Gregory;Toor, Jaspreet;Hogan, Alexandra B;Winskill, Peter;Ghani, Azra C
第一支非临床试验的COVID-19疫苗于2020年12月8日接种。为确保全球疫苗公平，COVAX基金和世卫组织制定了疫苗目标。然而，由于疫苗短缺，这些目标未能在2021年底实现。我们旨在量化COVID-19疫苗接种计划首年的全球影响。COVID-19传播和疫苗接种的数学模型分别拟合了185个国家和地区报告的COVID-19死亡率和全因超额死亡率。COVID-19疫苗接种计划的影响是通过估计在没有分发疫苗的情况下所损失的额外生命来确定的。我们亦估计，倘COVAX设定的20%疫苗接种覆盖率目标及世卫组织设定的40%疫苗接种覆盖率目标于二零二一年底前实现，本可避免的额外死亡人数。根据官方报告的COVID-19死亡人数，我们估计，2020年12月8日至2021年12月8日期间，185个国家和地区的疫苗接种预防了1440万（95%可信区间[Crl] 13.7 - 15.9）例COVID-19死亡。当我们使用超额死亡人数作为对疫情真实程度的估计时，该估计值上升至1，980万人（95% Crl 19·1-20·4）死于COVID-19，这意味着在COVID-19疫苗接种的第一年，全球总死亡人数减少了63%（3，140万人中的1，980万人）。在COVAX提前市场承诺国家，我们估计避免了41%的超额死亡率（1790万例死亡中的740万例[95%Crl 6.8 - 7.7]）。在低收入国家，我们估计，如果每个国家都实现了COVAX设定的20%疫苗接种覆盖率目标，则可以避免另外45%（95%CrI 42-49）的死亡，如果每个国家都实现了世卫组织设定的40%目标，则可以避免另外111%（105-118）的死亡。COVID-19疫苗接种大大改变了疫情的进程，挽救了全球数千万人的生命。然而，低收入国家无法充分获得疫苗，这限制了疫苗在这些环境中的影响，加强了全球疫苗公平和覆盖率的必要性。施密特科学奖学金，与罗兹信托基金会、世卫组织、英国医学研究理事会、疫苗联盟、比尔和梅林达·盖茨基金会、国家卫生研究所和Community Jameel合作。
The first COVID-19 vaccine outside a clinical trial setting was administered on Dec 8, 2020. To ensure global vaccine equity, vaccine targets were set by the COVID-19 Vaccines Global Access (COVAX) Facility and WHO. However, due to vaccine shortfalls, these targets were not achieved by the end of 2021. We aimed to quantify the global impact of the first year of COVID-19 vaccination programmes. A mathematical model of COVID-19 transmission and vaccination was separately fit to reported COVID-19 mortality and all-cause excess mortality in 185 countries and territories. The impact of COVID-19 vaccination programmes was determined by estimating the additional lives lost if no vaccines had been distributed. We also estimated the additional deaths that would have been averted had the vaccination coverage targets of 20% set by COVAX and 40% set by WHO been achieved by the end of 2021. Based on official reported COVID-19 deaths, we estimated that vaccinations prevented 14·4 million (95% credible interval [Crl] 13·7–15·9) deaths from COVID-19 in 185 countries and territories between Dec 8, 2020, and Dec 8, 2021. This estimate rose to 19·8 million (95% Crl 19·1–20·4) deaths from COVID-19 averted when we used excess deaths as an estimate of the true extent of the pandemic, representing a global reduction of 63% in total deaths (19·8 million of 31·4 million) during the first year of COVID-19 vaccination. In COVAX Advance Market Commitment countries, we estimated that 41% of excess mortality (7·4 million [95% Crl 6·8–7·7] of 17·9 million deaths) was averted. In low-income countries, we estimated that an additional 45% (95% CrI 42–49) of deaths could have been averted had the 20% vaccination coverage target set by COVAX been met by each country, and that an additional 111% (105–118) of deaths could have been averted had the 40% target set by WHO been met by each country by the end of 2021. COVID-19 vaccination has substantially altered the course of the pandemic, saving tens of millions of lives globally. However, inadequate access to vaccines in low-income countries has limited the impact in these settings, reinforcing the need for global vaccine equity and coverage. Schmidt Science Fellowship in partnership with the Rhodes Trust; WHO; UK Medical Research Council; Gavi, the Vaccine Alliance; Bill & Melinda Gates Foundation; National Institute for Health Research; and Community Jameel.