Research ArticleCORONAVIRUS

Vaccine optimization for COVID-19: Who to vaccinate first?

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Science Advances  03 Feb 2021:
Vol. 7, no. 6, eabf1374
DOI: 10.1126/sciadv.abf1374
  • Fig. 1 Simulated prevalence of symptomatic infections.

    Simulated prevalence of symptomatic COVID-19 infections for VE ranging from 10% (A) to 100% (J) in 10% increments. For each VE and each vaccination coverage, the optimal vaccine allocation for minimizing symptomatic infections was used in these simulations. Colors represent different vaccination coverage, ranging from 0% (black, “baseline”) to 100% (magenta). For clarity, we present here epidemic curves for the main set of parameters only and show a complete figure with uncertainty bounds in fig. S2.

  • Fig. 2 Four key metrics of COVID-19 burden under optimal distribution of vaccine.

    Percentage of symptomatic infections (A) and deaths (B) averted, and number of maximum non-ICU (C) and ICU (D) hospitalizations as a function of VE and vaccination coverage (total vaccine available as a percentage of the population). The dotted lines correspond to VE = 50% and vaccine available to cover 50% of the population. The isoclines indicate the current goal for Washington state having 10% of licensed general (non-ICU) hospital beds occupied by patients with COVID-19 in (C) and total ICU licensed hospital beds in Washington state in (D).

  • Fig. 3 Percentage of deaths averted under the optimal and the pro-rata strategies for different VE.

    Percentage of deaths averted for the optimal allocation strategy (blue) and the pro rata strategy (green) for VE ranging from 10 (A) to 100% (J) in 10% increments and vaccination coverage ranging from 10 to 100% of the total population. The shaded areas represent results of the 1000 simulations with the top and bottom 2.5% simulations removed.

  • Fig. 4 Optimal allocation strategies to minimize deaths for different VE.

    Optimal allocation strategies for minimizing deaths for VE ranging from 10 (A) to 100% (J) in 10% increments (additional figures for minimizing symptomatic infections, number of non-ICU hospitalizations at peak, and number of ICU hospitalizations at peak are given in the Supplementary Materials). For each plot, each row represents the total vaccination coverage available (percentage of the total population to be vaccinated), and each column represents a different vaccination group. Colors represent the percentage of the population in a given vaccination group to be vaccinated.

  • Fig. 5 Optimal allocation strategies for all objective functions analyzed.

    Optimal allocation strategies for minimizing: Symptomatic infections (A), number of non-ICU hospitalizations at peak (B), number of ICU hospitalizations at peak (C), and total number of deaths (D). Here, we assumed VE = 60%. For each plot, each row represents the total vaccination coverage available (percentage of the total population to be vaccinated), and each column represents a different vaccination group. Colors represent the percentage of the population in a given vaccination group to be vaccinated.

  • Fig. 6 Optimal allocation strategies for different VE with a vaccine including an effect against COVID-19 disease.

    Optimal allocation strategies for minimizing total symptomatic infections for VE ranging from 10% (A) to 60% (F) in 10% increments for VECOV = 60%. For each plot, each row represents the total vaccination coverage available (percentage of the total population to be vaccinated), and each column represents a different vaccination group. Colors represent the percentage of the population in a given vaccination group to be vaccinated.

  • Fig. 7 Three key metrics of COVID-19 burden under optimal distribution of vaccine for VECOV = 60%.

    Percentage of symptomatic infections averted (A) and number of maximum non-ICU (B) and ICU (C) hospitalizations as a function of VE and vaccination coverage (total vaccine available as a percentage of the population). The dotted lines correspond to VE = 50% and vaccine available to cover 50% of the population. The isoclines indicate the current goal for Washington state having 10% of licensed general (non-ICU) hospital beds occupied by patients with COVID-19 in (B) and total ICU licensed hospital beds in Washington state in (C).

  • Fig. 8 Optimal allocation strategies for minimizing deaths assuming different levels of pre-existing immunity in the population.

    Optimal allocation strategies for minimizing deaths assuming 10% (A), 20% (B), 30% (C), and 40% (D) of the population has natural immunity to COVID-19 at the start of the simulations. Here, we assumed VE = 60%. For each plot, each row represents the total vaccination coverage available (percentage of the total population to be vaccinated), and each column represents a different vaccination group. Colors represent the percentage of the population in a given vaccination group to be vaccinated.

  • Fig. 9 Optimal allocation strategies for minimizing deaths assuming different vaccination rates.

    Optimal allocation strategies for minimizing deaths for two VE = 50% (A to C) and 90% (D to F) and for three different vaccination rates: 75,000 (A and D), 150,000 (B and E), and 300,000 (C and F) vaccine doses administered per week. For each plot, each row represents the total vaccination coverage available (percentage of the total population to be vaccinated), and each column represents a different vaccination group. Colors represent the percentage of the population in a given vaccination group to be vaccinated.

  • Fig. 10 Optimal allocation strategies for minimizing deaths for different values of R0.

    Optimal allocation strategies for minimizing deaths for three different VE: 30% (A to C), 60% (D to F), and 90% (G to I) for three different values of R0 = 1.5, 2, and 2.5 (additional figures for minimizing symptomatic infections, number of non-ICU hospitalizations at peak, and number of ICU hospitalizations at peak are given in the Supplementary Materials). For each plot, each row represents the total vaccination coverage available (percentage of the total population to be vaccinated), and each column represents a different vaccination group. Colors represent the percentage of the population in a given vaccination group to be vaccinated.

Supplementary Materials

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