Age-targeted dose allocation can halve COVID-19 vaccine requirements

Meehan, Michael T.; Cocks, Daniel; Caldwell, Jamie M.; Trauer, James M.; Adekunle, Adeshina I.; Ragonnet, Romain; McBryde, Emma S.

doi:10.1101/2020.10.08.20208108

Cited by 35 publications

(37 citation statements)

References 27 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The social interaction patterns have a significant impact on “risk contacts” in Covid-19, as known from literature 27 , 28 , 29 and again shown in this study. Even imperfect immunity conveyed to a significant proportion of the age groups that fire the pandemic most is therefore highly desirable.…”

Section: Discussionsupporting

confidence: 78%

Impact of personalized-dose vaccination in Covid-19 with a limited vaccine supply in a 100 day period in the U.S.A.

Hunziker

2021

Preprint

View full text Add to dashboard Cite

Background: We aimed at minimizing loss of lives in the Covid-19 pandemic in the USA by identifying optimal vaccination strategies during a 100-day period with limited vaccine supplies. While lethality is highest in the elderly, transmission and case numbers are highest in the younger. A strategy of first vaccinating the elderly is widely used, thought to protect the vulnerable, elderly best. Despite lower immunogenicity in the elderly, mRNA vaccines retain high efficacy, implying that in the younger, reduced vaccine doses might suffice, thereby increasing vaccination counts with a given vaccine supply. Methods: Using published immunogenicity data of the Moderna mRNA-1273 vaccine, we examined the value of tailored-dose vaccination strategies, using a modeling approach incorporating age-related vaccine immunogenicity, social contact patterns, population structure, Covid-19 case and death rates in the USA in late January 2021. An increase if the number of persons that can be vaccinated and a potential reduction of the individual protective efficacy was accounted for. Results: Age-tailored dosing strategies reduced cases faster, shortening the pandemic, reducing the delay to reaching <100′000 cases/day from 64 to 30 days and avoiding 25′000 deaths within 100 days in the USA. In an ′elderly first′ vaccination strategy, mortality is higher even in the elderly. Findings were robust with transmission blocking efficacies of reduced dose vaccination between 30% to 90%. Conclusion: Rapid reduction of Covid-19 case and death rate in the USA in 100 days with a limited vaccine supply is best achieved when personalized, age-tailored dosing for highly effective vaccines is used. Protecting the vulnerable is most effectively achieved by dose tailored vaccination of all population segments, while an ′elderly first′ approach costs more lives, even in the elderly.

show abstract

Section: Discussionsupporting

confidence: 78%

Impact of personalized-dose vaccination in Covid-19 with a limited vaccine supply in a 100 day period in the U.S.A.

Hunziker

2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Notably, “protecting the vulnerable” is achieved best, when not only the vulnerable, but all population segments are immunized, in particular those that contribute more to drive the pandemic than the elderly 19,20,21 . A large number of infected young people combined with the imperfect protection achievable by vaccination in the elderly still represents a relevant threat to the vulnerable, rendering the strategy focusing on the elderly-first inferior to stopping the pandemic through a comprehensive approach.…”

Section: Discussionmentioning

confidence: 99%

Vaccination strategies for minimizing loss of life in Covid-19 in a Europe lacking vaccines

Hunziker

2021

Preprint

View full text Add to dashboard Cite

BackgroundWe aimed at identifying vaccination strategies that minimize loss of life in the Covid-19 pandemic. Covid-19 mainly kills the elderly, but the pandemic is driven by social contacts that are more frequent in the young. Vaccines elicit stronger immune responses per dose in younger persons. As vaccine production is a bottleneck, many countries have adopted a strategy of first vaccinating the elderly and vulnerable, while postponing vaccination of the young.MethodsBased on published age-stratified immunogenicity data of the Moderna mRNA-1273 vaccine, we compared the established “one dose fits all” approach with tailored strategies: The known differential immunogenicity of vaccine doses in different age groups is exploited to vaccinate the elderly at full dose, while the young receive a reduced dose, amplifying the number of individuals receiving the vaccine early. A modeling approach at European Union scale with population structure, Covid-19 case and death rates similar to Europe in late January 2021 is used.ResultsWhen the elderly were vaccinated preferentially, the pandemic initially continued essentially unchecked, as it was dominantly driven by social contacts in other age groups. Tailored strategies, including regular dosing in the elderly but reduced dose vaccination in the young, multiplied early vaccination counts, and even with some loss in protection degree for the individual person, the protective effect towards stopping the pandemic and protecting lives was enhanced, even for the elderly.ConclusionProtecting the vulnerable, minimizing overall deaths and stopping the pandemic is best achieved by an adaptive vaccination strategy using an age-tailored vaccine dose.

show abstract

“…These studies indicated that vaccinating school-aged children as well as their parents would be the optimal scenario when vaccine supply is limited in order to indirectly protect others in the community and, thus, reduce the number of severe health outcomes [ 12 , 13 , 15 ]. In the context of COVID-19 vaccination, Meehan et al assumed two distinct modes of action for potential vaccines: those that protect against initial infection and those that reduce the severity of symptoms [ 17 ]. The study by Meehan et al suggested that, in general, individuals aged 30–59 years should receive the highest priority for vaccination because of their high contact rates and high risk of infection [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the context of COVID-19 vaccination, Meehan et al assumed two distinct modes of action for potential vaccines: those that protect against initial infection and those that reduce the severity of symptoms [ 17 ]. The study by Meehan et al suggested that, in general, individuals aged 30–59 years should receive the highest priority for vaccination because of their high contact rates and high risk of infection [ 17 ]. However, Bubar et al found that in the USA, a transmission-blocking vaccine should be prioritized in younger adults (age 20–49 years) to minimize the cumulative incidence and in people older than 60 years to minimize mortality [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Optimal Allocation of the Limited COVID-19 Vaccine Supply in South Korea

Shim

2021

JCM

View full text Add to dashboard Cite

Initial supply of the coronavirus disease (COVID-19) vaccine may be limited, necessitating its effective use. Herein, an age-structured model of COVID-19 spread in South Korea is parameterized to understand the epidemiological characteristics of COVID-19. The model determines optimal vaccine allocation for minimizing infections, deaths, and years of life lost while accounting for population factors, such as country-specific age distribution and contact structure, and various levels of vaccine efficacy. A transmission-blocking vaccine should be prioritized in adults aged 20–49 years and those older than 50 years to minimize the cumulative incidence and mortality, respectively. A strategy to minimize years of life lost involves the vaccination of adults aged 40–69 years, reflecting the relatively high case-fatality rates and years of life lost in this age group. An incidence-minimizing vaccination strategy is highly sensitive to vaccine efficacy, and vaccines with lower efficacy should be administered to teenagers and adults aged 50–59 years. Consideration of age-specific contact rates and vaccine efficacy is critical to optimize vaccine allocation. New recommendations for COVID-19 vaccines under consideration by the Korean Centers for Disease Control and Prevention are mainly based on a mortality-minimizing allocation strategy.

show abstract

Age-targeted dose allocation can halve COVID-19 vaccine requirements

Cited by 35 publications

References 27 publications

Impact of personalized-dose vaccination in Covid-19 with a limited vaccine supply in a 100 day period in the U.S.A.

Impact of personalized-dose vaccination in Covid-19 with a limited vaccine supply in a 100 day period in the U.S.A.

Vaccination strategies for minimizing loss of life in Covid-19 in a Europe lacking vaccines

Optimal Allocation of the Limited COVID-19 Vaccine Supply in South Korea

Contact Info

Product

Resources

About