Transmission of COVID-19 in the presence of single-dose and double-dose vaccines with hesitancy: mathematical modeling and optimal control analysis

Abstract

IntroductionThe unexpected emergence of novel coronavirus identified as SAR-CoV-2 virus (severe acute respiratory syndrome corona virus 2) disrupted the world order to an extent that the human activities that are core to survival came almost to a halt. The COVID-19 pandemic created an insurmountable global health crisis that led to a united front among all nations to research on effective pharmaceutical measures that could stop COVID-19 proliferation. Consequently, different types of vaccines were discovered (single-dose and double-dose vaccines). However, the speed at which these vaccines were developed and approved to be administered created other challenges (vaccine skepticism and hesitancy).MethodThis paper therefore tracks the transmission dynamics of COVID-19 using a non-linear deterministic system that accounts for the unwillingness of both susceptible and partially vaccinated individuals to receive either single-dose or double-dose vaccines (vaccine hesitancy). Further the model is extended to incorporate three time-dependent non-pharmaceutical and pharmaceutical intervention controls, namely preventive control, control associated with screening-management of both truly asymptomatic and symptomatic infectious individuals and control associated with vaccination of susceptible individuals with a single dose vaccine. The Pontryagin's Maximum Principle is applied to establish the optimality conditions associated with the optimal controls.ResultsIf COVID-19 vaccines administered are imperfect and transient then there exist a parameter space where backward bifurcation occurs. Time profile projections depict that in a setting where vaccine hesitancy is present, administering single dose vaccines leads to a significant reduction of COVID-19 prevalence than when double dose vaccines are administered. Comparison of the impact of vaccine hesitancy against either single dose or double dose on COVID-19 prevalence reveals that vaccine hesitancy against single dose is more detrimental than vaccine hesitancy against a double dose vaccine. Optimal analysis results reveal that non-pharmaceutical time-dependent control significantly flattens the COVID-19 epidemic curve when compared with pharmaceutical controls. Cost-effectiveness assessment suggest that non-pharmaceutical control is the most cost-effective COVID-19 mitigation strategy that should be implemented in a setting where resources are limited.DiscussionPolicy makers and medical practitioners should assess the level of COVID-19 vaccine hesitancy inorder to decide on the type of vaccine (single-dose or double-dose) to administer to the population.