Optimizing vaccine allocation for COVID-19 vaccines shows the potential role of single-dose vaccination

  1. Laura Matrajt
  2. Julia Eaton
  3. Tiffany Leung
  4. Dobromir Dimitrov
  5. Joshua T. Schiffer
  6. David A. Swan
  7. Holly Janes

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Abstract

Most COVID-19 vaccines require two doses, however with limited vaccine supply, policymakers are considering single-dose vaccination as an alternative strategy. Using a mathematical model combined with optimization algorithms, we determined optimal allocation strategies with one and two doses of vaccine under various degrees of viral transmission. Under low transmission, we show that the optimal allocation of vaccine vitally depends on the single-dose efficacy. With high single-dose efficacy, single-dose vaccination is optimal, preventing up to 22% more deaths than a strategy prioritizing two-dose vaccination for older adults. With low or moderate single-dose efficacy, mixed vaccination campaigns with complete coverage of older adults are optimal. However, with modest or high transmission, vaccinating older adults first with two doses is best, preventing up to 41% more deaths than a single-dose vaccination given across all adult populations. Our work suggests that it is imperative to determine the efficacy and durability of single-dose vaccines, as mixed or single-dose vaccination campaigns may have the potential to contain the pandemic much more quickly.

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  3. Version published to 10.1038/s41467-021-23761-1
  4. Version published to 10.1101/2020.12.31.20249099v4 on medRxiv
  5. Version published to 10.1101/2020.12.31.20249099v3 on medRxiv
  6. Version published to 10.1101/2020.12.31.20249099v2 on medRxiv
  7. ScreenIT

    SciScore for 10.1101/2020.12.31.20249099: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our work has several limitations. Our model assumed that asymptomatic and symptomatic infections confer equal protection, but asymptomatic infections could result in weaker protection [48]. We assumed that naturally and vaccine-induced immunity will be at least six months, but the duration of immunity is not yet known; durable immune responses to the Moderna mRNA-1273 vaccine have been found through 3 months post-second-dose [49]. Ongoing phase 3 trials will establish the durability of vaccine efficacy, with participants followed 1 to 2 years post-last vaccination. If immunity is short-lived, then our results are valid only for that time frame. We also assumed that vaccinating previously infected individuals would have no effect on their immunity. However, limited data emerging suggests that previous infections might ‘prime’ the immune response, with only one dose boosting immunity [50]. This would be an important consideration for future work when evaluating vaccine allocation over longer time spans with waning immunity. We use age-stratified hospitalization rates based on data from Wuhan, China [51] and mortality rates based on data from France [52]. These rates strongly depend on comorbidities (e.g., heart disease, diabetes, etc.) that are country-dependent. It is then important to determine country-based estimates of these rates to adequately parameterize models. For mathematical and computational tractability, we used a deterministic model that does not account for geogr...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  8. Version published to 10.1101/2020.12.31.20249099v1 on medRxiv