Modelling optimal vaccination strategy for SARS-CoV-2 in the UK.
Modelling optimal vaccination strategy for SARS-CoV-2 in the UK.
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DOI：
10.1371/journal.pcbi.1008849
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发表时间：
2021-05
影响因子：
4.3
通讯作者：
Keeling MJ
中科院分区：
文献类型：
--
作者：
Moore S;Hill EM;Dyson L;Tildesley MJ;Keeling MJ
COVID-19爆发凸显了我们对新型感染的脆弱性。面对这种威胁，没有有效的治疗方法，与许多其他国家一样，英国采取了强制性的社会距离（锁定）来减少传播-成功地将生殖数R降低到1以下。然而，鉴于仍有大量易感个体，完全放松控制很可能导致进一步大规模爆发。接种疫苗仍然是控制感染和恢复正常互动和行为的唯一可预见的手段。在这里，我们考虑在英国接种疫苗的最佳目标，以尽量减少未来的死亡或质量调整生命年（QALY）的损失。我们表明，对于一系列关于疫苗作用和效力的假设，首先针对老年群体是最佳的，如果疫苗既能预防疾病，又能预防传播，可能足以遏制疫情。与地球仪大多数其他国家一致，在缺乏疫苗或药物治疗的情况下，英国严重依赖非药物社会措施来控制COVID-19大流行的影响。虽然事实证明，与不受控制的疫情相比，这在减轻医疗负担方面是有效的，但这对经济、教育和许多其他社会因素造成了损害。随着疫苗的发展，减轻疾病，这是非常重要的，他们提供了一个最佳的方式，降低死亡率和医疗保健需求。使用SARS-CoV-2传播的年龄结构数学模型，我们测试了不同的疫苗订购策略，以确定哪些社会成员应该首先接种疫苗，以实现特定的健康目标。在所有情况下，我们发现首先为最年长和最脆弱的人接种疫苗的影响最大，尽管任何疫苗接种计划的最终成功将在很大程度上取决于疫苗本身的特点和人口吸收水平。
The COVID-19 outbreak has highlighted our vulnerability to novel infections. Faced with this threat and no effective treatment, in line with many other countries, the UK adopted enforced social distancing (lockdown) to reduce transmission—successfully reducing the reproductive number R below one. However, given the large pool of susceptible individuals that remain, complete relaxation of controls is likely to generate a substantial further outbreak. Vaccination remains the only foreseeable means of both containing the infection and returning to normal interactions and behaviour. Here, we consider the optimal targeting of vaccination within the UK, with the aim of minimising future deaths or quality adjusted life year (QALY) losses. We show that, for a range of assumptions on the action and efficacy of the vaccine, targeting older age groups first is optimal and may be sufficient to stem the epidemic if the vaccine prevents transmission as well as disease. In line with most other countries across the globe, and in the absence of a vaccine or pharmaceutical treatments, the UK has relied heavily upon non-pharmaceutical social measures to control the impact of the COVID-19 pandemic. While this has proved effective in reducing the healthcare burden compared to an uncontrolled outbreak, this is achieved to the detriment of the economy, education and many other societal factors. As vaccines are developed which mitigate the disease, it is of great importance that they are delivered in an optimal manner—reducing mortality and healthcare demands. Using an age-structured mathematical model of SARS-CoV-2 transmission, we test different vaccine ordering strategies to identify which members of society should be targeted for vaccination first in order to achieve a specified health objective. In all scenarios we find vaccinating the most elderly and vulnerable first to have the greatest impact, though the ultimate success of any vaccination scheme will be highly contingent on the characteristics of the vaccine itself and the level of population uptake.
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影响因子：
4.3
作者：
Hill, Edward M.;Petrou, Stavros;Keeling, Matt J.
通讯作者：
Keeling, Matt J.
影响因子：
9.2
作者：
Graham, Simon P.;McLean, Rebecca K.;Lambe, Teresa
通讯作者：
Lambe, Teresa
DOI：
10.1098/rsif.2010.0474
发表时间：
2011-05-06
期刊：
Journal of the Royal Society, Interface
影响因子：
--
作者：
Keeling MJ;White PJ
通讯作者：
White PJ
DOI：
10.1098/rspb.1999.0716
发表时间：
1999-04-22
影响因子：
4.7
作者：
Keeling, MJ
通讯作者：
Keeling, MJ
影响因子：
5.5
作者：
Bartsch, Sarah M.;O'Shea, Kelly J.;Lee, Bruce Y.
通讯作者：
Lee, Bruce Y.