Abstract
In vaccination campaigns against COVID-19, many jurisdictions are using age-based rollout strategies, reflecting the much higher risk of severe outcomes of infection in older groups. In the wake of growing evidence that approved vaccines are effective at preventing not only adverse outcomes, but also infection, we show that such strategies are less effective than strategies that prioritize essential workers. This conclusion holds across numerous outcomes, including cases, hospitalizations, Long COVID (cases with symptoms lasting longer than 28 days), deaths and net monetary benefit. Our analysis holds in regions where the vaccine supply is limited, and rollout is prolonged for several months. In such a setting with a population of 5M, we estimate that vaccinating essential workers sooner prevents over 200,000 infections, over 600 deaths, and produces a net monetary benefit of over $500M.
Highlights
As of March 2021, several vaccines have received widespread approval for use against COVID19 [1]
Our model is an extension of the framework introduced by Bubar et al [28], but considers both age and essential worker status; in addition, we explore Long COVID and chronic outcomes
We find that vaccinating essential workers earlier gives large reductions in infections, hospitalizations, deaths, and instances of Long COVID, across a range of scenarios for transmission and vaccine efficacy
Summary
As of March 2021, several vaccines have received widespread approval for use against COVID19 [1]. Many jurisdictions are using primarily agebased rollout strategies, where the oldest are vaccinated first and the youngest last, with the rationale that the risk of severe outcomes from COVID-19 steeply increases with age. Such strategies may appear optimal if we are only considering the ability of the vaccines to prevent illness, and/or if everyone is likely to be exposed. Data on the reduction of infection and transmission from vaccination are accumulating as more countries deploy vaccines. Recent phase 3 trials have shown that the Moderna vaccine [2], the PfizerBioNTech vaccine [3], and the AstraZeneca [4] vaccine are effective at preventing symptomatic infection and severe illness.
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