Optimising the impact of COVID-19 vaccination on mortality and hospitalisations using an individual additive risk measuring approach based on a risk adjustment scheme

Wende, Danny; Hertle, Dagmar; Schulte, Claudia; Ballesteros, Pedro; Repschläger, Uwe

doi:10.1007/s10198-021-01408-8

Cited by 3 publications

(2 citation statements)

References 22 publications

(19 reference statements)

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“…In contrast to an earlier work (Wende et al 2022 ), we decided to develop a score in a cohort of COVID-19 patients instead of the general population. Hence, our results are not confounded by different probabilities of contracting the disease within the populations with risk factors (e.g., strict self-isolation) as we only assess the impact of risk factors on severe course of COVID-19 once infected.…”

Section: Discussionmentioning

confidence: 99%

Development of a risk score to identify patients at high risk for a severe course of COVID-19

Jacob

Tesch

Wende³

et al. 2023

J Public Health (Berl.)

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Aim We aimed to develop a risk score to calculate a person’s individual risk for a severe COVID-19 course (POINTED score) to support prioritization of especially vulnerable patients for a (booster) vaccination. Subject and methods This cohort study was based on German claims data and included 623,363 individuals with a COVID-19 diagnosis in 2020. The outcome was COVID-19 related treatment in an intensive care unit, mechanical ventilation, or death after a COVID-19 infection. Data were split into a training and a test sample. Poisson regression models with robust standard errors including 35 predefined risk factors were calculated. Coefficients were rescaled with a min–max normalization to derive numeric score values between 0 and 20 for each risk factor. The scores’ discriminatory ability was evaluated by calculating the area under the curve (AUC). Results Besides age, down syndrome and hematologic cancer with therapy, immunosuppressive therapy, and other neurological conditions were the risk factors with the highest risk for a severe COVID-19 course. The AUC of the POINTED score was 0.889, indicating very good predictive validity. Conclusion The POINTED score is a valid tool to calculate a person’s risk for a severe COVID-19 course.

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Section: Discussionmentioning

confidence: 99%

Development of a risk score to identify patients at high risk for a severe course of COVID-19

Jacob

Tesch

Wende³

et al. 2023

J Public Health (Berl.)

Self Cite

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“…Two studies noted that there are large benefits to using more than just age in the targeting strategy. 3,9 Chapman et al found that targeting by two or more risk factors simultaneously averted up to 40% more disability-adjusted life years (DALYs). 3…”

Section: Introductionmentioning

confidence: 99%

Data-driven Targeting of COVID-19 Vaccination Programs: An Analysis of the Evidence on Impact, Implementation, Ethics and Equity

McLaren

2023

Preprint

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The data-driven targeting of COVID-19 vaccination programs is a major determinant of the ongoing toll of COVID-19. Targeting of access to, outreach about and incentives for vaccination can reduce total deaths by 20-50 percent relative to a first-come-first-served allocation. This piece performs a systematic review of the modeling literature on the relative benefits of targeting different groups for vaccination and evaluates the broader scholarly evidence -- including analyses of real-world challenges around implementation, equity, and other ethical considerations -- to guide vaccination targeting strategies. Three-quarters of the modeling studies reviewed concluded that the most effective way to save lives, reduce hospitalizations and mitigate the ongoing toll of COVID-19 is to target vaccination program resources to high-risk people directly rather than reducing transmission by targeting low-risk people. There is compelling evidence that defining vulnerability based on a combination of age, occupation, underlying medical conditions and geographic location is more effective than targeting based on age alone. Incorporating measures of economic vulnerability into the prioritization scheme not only reduces mortality but also improves equity. The data-driven targeting of COVID-19 vaccination program resources benefits everyone by efficiently mitigating the worst effects of the pandemic until the threat of COVID-19 has passed.

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COVID-19 vaccination and governance in the case of low, middle and high-income countries

Lupu

Ţigănaşu

2023

BMC Public Health

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Background Global crises, regardless of the place where they started to spread or of the factors that triggered them, require a comprehensive approach, primarily based on good communication, cooperation and mutual support. No individual and no institution should remain indifferent to crises but, on the contrary, be fully aware that any involvement in curbing them matters. Although humanity can be affected by various types of crises, in this paper we refer to the one related to COVID-19 pandemic. There are certain reasons that come to justify our choice: first of all, being a shock with a strong impact on people, its analysis should be performed from several angles; this may bring to light an image with its disparate propagation and measures to counteract it both in developed countries, and especially in those with a shortage of resources. Secondly, in the context of the emergence of vaccines against COVID-19, it is helpful to have an overview of COVID-19 through the lens of the relationship between the vaccination process and the elements that characterize governance, with a differentiated dashboard by country categories worldwide: low, middle and high-income countries. Our study is far from capturing the complexity arising from such social problem, but rather aims to outline the defining role of governance when it comes to providing firm reactions to the COVID-19 crisis. Methods Given that our sample consists of a large number of countries, namely 170, first, examined all together, and then, split into three groups (high, middle and low-income), it is challenging to address governance in association with COVID-19 vaccination, in order to see how much they interact and how each of the six aggregate governance indicators of the World Bank (Worldwide Governance Indicators) is reflected in this process. Even if they do not oscillate strongly over relatively short periods of time, reporting on health issues requires a sequential inventory, considering closer time intervals, so as to be able to act promptly. Thus, to better distinguish how the COVID-19 vaccination process evolved in low, middle and high-income countries, but also how it was imprinted by governance, we present the situation quarterly (March, June, September and December), in 2021, the year when the immunization campaigns were the most intense at the global level. Regarding the applied methods, we mention both OLS regressions with robust estimators and a panel model, used to investigate the determinants of COVID-19 vaccination, some of them describing the good governance, as well as other dimensions. Results The findings point out that the influence of governance on COVID-19 vaccination differs depending on whether a country belongs to high, middle or low-income typology: the strongest determinism of governance on vaccination is encountered in high-income countries, and the weakest in low-income ones; in some cases, governance does not matter significantly. However, exploring the three groups of states included in the research, it is observed that the most relevant factors in this relationship are government effectiveness, regulatory quality and control of corruption. Conclusions Besides the order of importance of governance indicators on COVID-19 vaccination, our study indicates that, overall, governance positively shapes the vaccination rate at the level of the chosen sample. In normative terms, these findings can be translated particularly by the fact that they can serve as information to raise awareness on the relevance of the existence of an institutional framework that allows the formulation of strategies according to the patterns of each country, especially since the actionable tools depend on the available resources. As a general conclusion, public policies should be designed in such a way as to strengthen trust in vaccination regulations and in governments, to reduce the multifaceted negative effects of this health crisis and to hope for its total end.

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Optimising the impact of COVID-19 vaccination on mortality and hospitalisations using an individual additive risk measuring approach based on a risk adjustment scheme

Cited by 3 publications

References 22 publications

Development of a risk score to identify patients at high risk for a severe course of COVID-19

Development of a risk score to identify patients at high risk for a severe course of COVID-19

Data-driven Targeting of COVID-19 Vaccination Programs: An Analysis of the Evidence on Impact, Implementation, Ethics and Equity

COVID-19 vaccination and governance in the case of low, middle and high-income countries

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