Modelled Optimization of SARS-Cov-2 Vaccine Distribution: an Evaluation of Second Dose Deferral Spacing of 6, 12, and 24 weeks

  1. GT Jurgens
  2. K Lackner

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Abstract

Background

Multiple recent studies have shown strong first dose vaccine efficacy for both Moderna mRNA-1273 and Pfizer/BioNTech BNT 162b2, which has stimulated discussion of maximizing initial population immunity during a time of vaccine shortage by using a deferred second dose strategy for these vaccines.

Methods

Our model examines the size of the effect of spacing of the second dose with 6, 12, and 24 week deferred spacing regimens relative to 3 week spacing.

Results

Deferring the second dose from 3 weeks to 6 weeks, 12 weeks, and 24 weeks shows progressive benefit to population immunity for any given time period, even with significant one dose efficacy decay. The benefits are influenced by vaccine supply per capita.

Conclusion

The longer the second dose is deferred the larger the benefit in initial population immunity, provided one dose efficacy does not significantly wane. Monitoring one dose efficacy duration from the UK or Quebec minimizes this risk, as the gathered data will help ensure the second dose is given at an optimal time. How this information is implemented should vary depending on the population and whether the goal is to optimally protect high risk groups or to increase total population immunity as quickly as possible. Benefits to deferring the second dose are influenced by the length of deferral, one dose efficacy, and vaccine supply per capita. The time to herd immunity could be shortened by 4 weeks with the implementation of a 12 week spacing regimen or 10 weeks with a 24 week spacing regimen.

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  1. ScreenIT

    SciScore for 10.1101/2021.02.28.21252638: (What is this?)

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

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    We developed a model using a Python script to estimate the benefits to increased population immunity of deferring the second dose of the mRNA vaccines from 3 weeks to 6, 12, and 24 weeks.
    Python
    suggested: (IPython, RRID:SCR_001658)

    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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    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.

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  2. Version published to 10.1101/2021.02.28.21252638v2 on medRxiv
  3. Version published to 10.1101/2021.02.28.21252638v1 on medRxiv