Abstract
SARS-CoV-2 is currently causing hundreds of deaths every day in European countries, mostly in not yet vaccinated elderly. Vaccine shortage poses relevant challenges to health authorities, called to act promptly with a scarcity of data. We modeled the mortality reduction of the elderly according to a schedule of mRNA SARS-CoV-2 vaccine that prioritized first dose administration. For the case study of Italy, we show an increase in protected individuals up to 53.4% and a decrease in deaths up to 19.8% in the cohort of over 80's compared with the standard vaccine recalls after 3 or 4 weeks. This model supports the adoption of vaccination campaigns that prioritize the administration of the first doses in the elderly.
Highlights
Despite the restrictive measures adopted worldwide, the daily count of infections and deaths from COVID-19 remains high and unbearable
The recommendation derived from registrative trials is that administration of the mRNA vaccines should be in two doses, spaced 3–4 weeks apart: the efficacy of preventing symptomatic COVID-19 in clinical trials was 94.8 and 94.1% for Pfizer/BNT Biotech and Moderna, respectively [2, 3]
We provide a computation of the expected benefits to support the choice of the best vaccination strategy
Summary
Despite the restrictive measures adopted worldwide, the daily count of infections and deaths from COVID-19 remains high and unbearable. A recent Israeli study estimated first dose effectiveness (protection assessed in the real world, usually lower than efficacy) of 85% (95% CI 71–92) in reducing symptomatic COVID-19 cases [5] In Italy, the available doses of the two mRNA vaccines are much lower than those needed to immunize the entire population or even the over-80’s in a short time This situation is putting Italy, and other countries like the U.S, in front of a question similar to that faced by the United Kingdom: if the first objective is to save the greatest number of lives, why not delay the second doses until all high-risk subjects have been vaccinated with at least one dose?. If the second dose is administered >3 weeks after the first Pfizer-BioNTech vaccine dose or >1 month after the first Moderna vaccine dose, there is no need to restart the series” [18]
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