Abstract
With limited availability of vaccines, an efficient use of the limited supply of vaccines in order to achieve herd immunity will be an important tool to combat the wide-spread prevalence of COVID-19. Here, we compare a selection of strategies for vaccine distribution, including a novel targeted vaccination approach (EHR) that provides a noticeable increase in vaccine impact on disease spread compared to age-prioritized and random selection vaccination schemes. Using high-fidelity individual-based computer simulations with Oslo, Norway as an example, we find that for a community reproductive number in a setting where the base pre-vaccination reproduction number R = 2.1 without population immunity, the EHR method reaches herd immunity at 48% of the population vaccinated with 90% efficiency, whereas the common age-prioritized approach needs 89%, and a population-wide random selection approach requires 61%. We find that age-based strategies have a substantially weaker impact on epidemic spread and struggle to achieve herd immunity under the majority of conditions. Furthermore, the vaccination of minors is essential to achieving herd immunity, even for ideal vaccines providing 100% protection.
Highlights
Population-wide vaccination is the most promising approach for long-term COVID-19 disease management [1]
For the purposes of this article, we consider four vaccination strategies: A random approach where all individuals are likely to be selected for vaccination, one where selection is according to decreasing age, one in which adults (18 and above) are selected by increasing age, and a novel strategy we call “effective household reduction” (EHR) which we describe below in more detail
Looking at the intersect between the R-curves and the herd immunity threshold (i.e., R = 1), we find that EHR exhibits a modest advantage compared to random vaccination, with a more substantial edge relative to the elderly-first strategy
Summary
Population-wide vaccination is the most promising approach for long-term COVID-19 disease management [1]. Due to limited vaccine availability, in particular in the early stages of deployment, most authorities have to choose between vaccination prioritization schemes, aiming for a balance between total mortality, years of life lost, and cumulative levels of infections. In responding to the COVID-19 pandemic, many countries have opted for a strategy of suppressing infection rates (with varying success) through stringent social, work and travel restrictions until a sufficient amount of vaccines are deployed to adequately mitigate the public health risks of COVID-19. There are two criteria which individually satisfy the latter objective.
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