Estimating the distribution of COVID-19-susceptible, -recovered, and -vaccinated individuals in Germany up to April 2022
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Abstract
After having affected the population for two years, the COVID-19 pandemic has reached a phase where a considerable number of people in Germany have been either infected with a SARS-CoV-2 variant, vaccinated, or both. Yet the full extent to which the population has been in contact with either virus or vaccine remains elusive, particularly on a regional level, because (a) infection counts suffer from under-reporting, and (b) the overlap between the vaccinated and recovered subpopulations is unknown. Since previous infection, vaccination, or especially a combination of both reduce the risk of severe disease, a high share of individuals with SARS-CoV-2 immunity lowers the probability of severe outbreaks that could potentially overburden the public health system once again, given that emerging variants do not escape this reduction in susceptibility. Here, we estimate the share of immunologically naïve individuals by age group for each of the 16 German federal states by integrating an infectious disease model based on weekly incidences of SARS-CoV-2 infections in the national surveillance system and vaccine uptake, as well as assumptions regarding under-ascertainment. We estimate a median share of 7.0% of individuals in the German population have neither been in contact with vaccine nor any variant as of March 31, 2022 (quartile range [3.6%– 9.8%]). For the adult population at higher risk of severe disease, this figure is reduced to 3.5% [1.3%–5.5%] for ages 18–59 and 4.3% [2.7%–5.8%] for ages 60 and above. However, estimates vary between German states mostly due to heterogeneous vaccine uptake. Excluding Omicron infections from the analysis, 16.1% [14.0%–17.8%] of the population in Germany, across all ages, are estimated to be immunologically naïve, highlighting the large impact the Omicron wave had until the beginning of spring in 2022.
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SciScore for 10.1101/2022.04.19.22274030: (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
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our results are subject to a number of limitations and biases. For instance, the reported uncertainties (quartile ranges) are heavily determined by the choice of distribution of aϕ. The distribution we chose has a median value of Q2 [aϕ] = 1.7, which is slightly lower than what was observed in 2020 [18]. Moreover, the lower distribution bound of min(aϕ) = 1 might be rather low, as such a value would mean that every infection has been …
SciScore for 10.1101/2022.04.19.22274030: (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
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our results are subject to a number of limitations and biases. For instance, the reported uncertainties (quartile ranges) are heavily determined by the choice of distribution of aϕ. The distribution we chose has a median value of Q2 [aϕ] = 1.7, which is slightly lower than what was observed in 2020 [18]. Moreover, the lower distribution bound of min(aϕ) = 1 might be rather low, as such a value would mean that every infection has been reported, which is unlikely. Hence, at least the upper percentiles we report for S∞ might be overestimations. Furthermore, we assume the same distribution of under-ascertainment ratios for all German states, which might not reflect potential heterogeneities in local ascertainment particularly well. Regarding modeling choices for the eligibility time, a short average duration after infection to be eligible for vaccination leads to larger proportions of vaccine-eligible people and, hence, to a higher overlap between the vaccinated and recovered subpopulations, thus increasing the estimated number of fully susceptibles. While we chose a comparably low value of 90d for this parameter, lower values cannot be ruled out. However, (i) the value we chose lies below the official recommendation, and (ii) changes in this parameter are not expected to change our results drastically, as was shown in a sensitivity analysis. Likewise, shorter durations of eligibility for reinfection and lower values of long-term immunity of recovered individuals increase the lik...
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.
Results from scite Reference Check: We found no unreliable references.
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