A modelling study investigating short and medium-term challenges for COVID-19 vaccination: From prioritisation to the relaxation of measures. (August 2021)

• Record Type: Journal Article
• Authors: Tran Kiem, Cécile; Massonnaud, Clément R.; Levy-Bruhl, Daniel; Poletto, Chiara; Colizza, Vittoria; Bosetti, Paolo; Fontanet, Arnaud; Gabet, Amélie; Olié, Valérie; Zanetti, Laura; Boëlle, Pierre-Yves; Crépey, Pascal; Cauchemez, Simon
• Is Part Of: EClinicalMedicine. Volume 38(2021)
• Publication Date: 2021-08
• Subjects: COVID-19 -- SARS-CoV-2 -- Vaccination -- Prioritisation -- Relaxation of measures -- Comorbidities; Medicine -- Research -- Periodicals; Medical policy -- Periodicals; Clinical Medicine; Health Policy; Public Health; Medical policy; Medicine -- Research; Periodical; Electronic journals; Periodicals; 613
• DOI: 10.1016/j.eclinm.2021.101001
• Languages: English
• ISSNs: 2589-5370

Abstract

Abstract: Background: The roll-out of COVID-19 vaccines is a multi-faceted challenge whose performance depends on pace of vaccination, vaccine characteristics and heterogeneities in individual risks. Methods: We developed a mathematical model accounting for the risk of severe disease by age and comorbidity, and transmission dynamics. We compared vaccine prioritisation strategies in the early roll-out stage and quantified the extent to which measures could be relaxed as a function of the vaccine coverage achieved in France. Findings: Prioritizing at-risk individuals reduces morbi-mortality the most if vaccines only reduce severity, but is of less importance if vaccines also substantially reduce infectivity or susceptibility. Age is the most important factor to consider for prioritization; additionally accounting for comorbidities increases the performance of the campaign in a context of scarce resources. Vaccinating 90% of ≥65 y.o. and 70% of 18–64 y.o. before autumn 2021 with a vaccine that reduces severity by 90% and susceptibility by 80%, we find that control measures reducing transmission rates by 15–27% should be maintained to remain below 1000 daily hospital admissions in France with a highly transmissible variant (basic reproduction number R0 = 4). Assuming 90% of ≥65 y.o. are vaccinated, full relaxation of control measures might be achieved with a vaccine coverage of 89–100% in 18–64 y.o or 60–69% of 0–64 y.o. Interpretation: Age and comorbidity-based vaccine prioritization strategies could reduce the burden of the disease. Very high vaccination coverage may be required to completely relax control measures. Vaccination of children, if possible, could lower coverage targets necessary to achieve this objective. Funding: We acknowledge financial support from Haute Autorite de Sante, the Investissement d'Avenir program, the Laboratoire d'Excellence Integrative Biology of Emerging Infectious Diseases program (grant ANR-10-LABX-62-IBEID), Sante Publique France, the INCEPTION project (PIA/ANR-16-CONV-0005), AXA, Groupama and the European Union's Horizon 2020 research and innovation program under grants 101003589 (RECOVER) and 874735 (VEO).