Abstract
(1) Background: The Austrian supply of COVID-19 vaccine is limited for now. We aim to provide evidence-based guidance to the authorities in order to minimize COVID-19-related hospitalizations and deaths in Austria. (2) Methods: We used a dynamic agent-based population model to compare different vaccination strategies targeted to the elderly (65 ≥ years), middle aged (45–64 years), younger (15–44 years), vulnerable (risk of severe disease due to comorbidities), and healthcare workers (HCW). First, outcomes were optimized for an initially available vaccine batch for 200,000 individuals. Second, stepwise optimization was performed deriving a prioritization sequence for 2.45 million individuals, maximizing the reduction in total hospitalizations and deaths compared to no vaccination. We considered sterilizing and non-sterilizing immunity, assuming a 70% effectiveness. (3) Results: Maximum reduction of hospitalizations and deaths was achieved by starting vaccination with the elderly and vulnerable followed by middle-aged, HCW, and younger individuals. Optimizations for vaccinating 2.45 million individuals yielded the same prioritization and avoided approximately one third of deaths and hospitalizations. Starting vaccination with HCW leads to slightly smaller reductions but maximizes occupational safety. (4) Conclusion: To minimize COVID-19-related hospitalizations and deaths, our study shows that elderly and vulnerable persons should be prioritized for vaccination until further vaccines are available.
Highlights
Worldwide, the newly emerged pandemic severe acute respiratory syndrome coronavirus type-2 virus (SARS-CoV-2) has led to enormous health, social, and economic burdens.Severe cases of coronavirus disease 2019 (COVID-19) are associated with increased mortality and hospitalizations, overwhelming many healthcare systems
To evaluate the effect of different sequential strategies for the vaccination of different target groups, we considered five a priori-defined population groups, which were defined in a workshop with the Standing Policy and Expert Panel TAV-COVID: (1) elderly: 65 years and older (E; 1.7 million); (2) middle aged: 45–64 years old (M; 2.7 million); (3) young adults: 15–44 years old (Y; 3.4 million) [29]; (4) vulnerable: individuals with comorbidities leading to an increased risk for a severe course of COVID-19 (V; 2.9 million) [30,31]; and
If the goal is to minimize COVID-19-related deaths, hospitalizations, or both, elderly and vulnerable persons should be prioritized for vaccination, followed by middle-aged persons, healthcare workers, and younger individuals
Summary
The newly emerged pandemic severe acute respiratory syndrome coronavirus type-2 virus (SARS-CoV-2) has led to enormous health, social, and economic burdens.Severe cases of coronavirus disease 2019 (COVID-19) are associated with increased mortality and hospitalizations, overwhelming many healthcare systems. Vaccines can provide direct protection, for example, prevention of disease, or they can prevent infections and thereby prevent transmission too. Depending on these characteristics, the vaccination strategy may focus on the protection of those who are at the highest risk of severe disease such as patients with cancer, human immunodeficiency viruses (HIV), pregnant women, or patients undergoing immunosuppression treatments [7,8,9]. Vaccination of other specific subpopulations (e.g., children or young adults who tend to have more contacts and are more mobile), may be an optimal target group to successfully prevent virus transmission and epidemic spread of the virus, as has been reported for influenza epidemics, children appear to play a less important role for of SARS-CoV2 as compared to influenza viruses [15]. Vaccinating essential workers including healthcare workers (HCW) is crucial to maintain healthcare and other system services and reduces the risk of virus transmission to patients and nursing home residents [16,17]
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