Global, regional, and national estimates of target population sizes for covid-19 vaccination: descriptive study

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Abstract

Objective

To provide global, regional, and national estimates of target population sizes for coronavirus disease 2019 (covid-19) vaccination to inform country specific immunisation strategies on a global scale.

Design

Descriptive study.

Setting

194 member states of the World Health Organization.

Population

Target populations for covid-19 vaccination based on country specific characteristics and vaccine objectives (maintaining essential core societal services; reducing severe covid-19; reducing symptomatic infections and stopping virus transmission).

Main outcome measure

Size of target populations for covid-19 vaccination. Estimates use country specific data on population sizes stratified by occupation, age, risk factors for covid-19 severity, vaccine acceptance, and global vaccine production. These data were derived from a multipronged search of official websites, media sources, and academic journal articles.

Results

Target population sizes for covid-19 vaccination vary markedly by vaccination goal and geographical region. Differences in demographic structure, presence of underlying conditions, and number of essential workers lead to highly variable estimates of target populations at regional and country levels. In particular, Europe has the highest share of essential workers (63.0 million, 8.9%) and people with underlying conditions (265.9 million, 37.4%); these two categories are essential in maintaining societal functions and reducing severe covid-19, respectively. In contrast, South East Asia has the highest share of healthy adults (777.5 million, 58.9%), a key target for reducing community transmission. Vaccine hesitancy will probably impact future covid-19 vaccination programmes; based on a literature review, 68.4% (95% confidence interval 64.2% to 72.6%) of the global population is willing to receive covid-19 vaccination. Therefore, the adult population willing to be vaccinated is estimated at 3.7 billion (95% confidence interval 3.2 to 4.1 billion).

Conclusions

The distribution of target groups at country and regional levels highlights the importance of designing an equitable and efficient plan for vaccine prioritisation and allocation. Each country should evaluate different strategies and allocation schemes based on local epidemiology, underlying population health, projections of available vaccine doses, and preference for vaccination strategies that favour direct or indirect benefits.

Article activity feed

  1. SciScore for 10.1101/2020.09.29.20200469: (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 variableSecond, to reduce severe COVID-19 disease (i.e., hospitalizations, critical care admissions, and deaths), people with underlying conditions [i.e., cardiovascular disease, chronic kidney disease, chronic respiratory disease, chronic liver disease, diabetes, cancer with direct immunosuppression, cancer without direct immunosuppression but with possible immunosuppression caused by treatment, HIV/AIDS, tuberculosis (excluding latent infections), chronic neurological disorders and sickle cell disorders] (14), those older than 60 years of age without any underlying conditions, as well as pregnant women should be included as a candidate priority groups.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    S1 for data sources), including the 1) United Nations (UN) mid-year population estimates for 2020 for 194 WHO member states (and countries/territories); 2) country-specific sizes of the military population from the World Bank Group or searching Baidu, Bing, and Google search engines using the search terms “military size” and World Health Organization country names; 3) the density of physicians, nurses and midwiferies by country from the World Bank and the World Health Organization; 4) the number of people working in the electricity, gas, water, steam and air conditioning sectors, food, accommodation, domestic transportation and storage industries, using census data on economically active population in 152 countries; 5) the number of individuals at increased risk of severe COVID-19 by age and country from previous report by Clark A, et al. (14).
    Google
    suggested: (Google, RRID:SCR_017097)

    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:
    Given these limitations, between-country variations in vaccine acceptance and delivery need to be considered when tailoring COVID-19 vaccine allocation and distribution to each locale. We estimated that approximately 15.6 billion doses of a COVID-19 vaccine will be requested by 194 WHO Member States for a universal COVID-19 vaccination program, given a two-dose regimen. Assuming all of the vaccine manufacturers with existing candidates can offer vaccines concurrently, the global production capacity of COVID-19 vaccine is estimated at 3.5 billion doses annually (7). Not enough vaccine will be available at the beginning of a COVID-19 vaccination program, even in an optimistic scenario. To achieve herd immunity by protecting at least 60-80% of individuals (4.7 to 6.2 billion), it will take about 17 to 22 months to produce enough COVID-19 vaccines. Vaccine supply and delivery services will constrain the roll-out of COVID-19 vaccination programs as well. In this context, the same barriers would apply to all target groups, but vaccination of targeted occupational or high-risk groups will likely be more feasible than the general public without any underlying conditions. This together comprise an estimated 2.51 billion people in 194 WHO Member States. Within- and between-region disparities in the distribution of each target population highlight different demands for COVID-19 vaccine. These disparities will result in different durations of vaccination program, due to global limitation...

    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

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.