Epidemiological impact of prioritising SARS-CoV-2 vaccination by antibody status: mathematical modelling analyses

Author:

Ayoub Houssein H,Chemaitelly Hiam,Makhoul Monia,Al Kanaani Zaina,Al Kuwari Einas,Butt Adeel A,Coyle Peter,Jeremijenko Andrew,Kaleeckal Anvar Hassan,Latif Ali Nizar,Shaik Riyazuddin Mohammad,Abdul Rahim Hanan F,Nasrallah Gheyath K,Yassine Hadi M,Al Kuwari Mohamed G,Al Romaihi Hamad Eid,Al-Thani Mohamed H,Bertollini Roberto,Al Khal Abdullatif,Abu-Raddad Laith JORCID

Abstract

BackgroundVaccines against SARS-CoV-2 have been developed, but their availability falls far short of global needs. This study aimed to investigate the impact of prioritising available doses on the basis of recipient antibody status, that is by exposure status, using Qatar as an example.MethodsVaccination impact (defined as the reduction in infection incidence and the number of vaccinations needed to avert one infection or one adverse disease outcome) was assessed under different scale-up scenarios using a deterministic meta-population mathematical model describing SARS-CoV-2 transmission and disease progression in the presence of vaccination.ResultsFor a vaccine that protects against infection with an efficacy of 95%, half as many vaccinations were needed to avert one infection, disease outcome or death by prioritising antibody-negative individuals for vaccination. Prioritisation by antibody status reduced incidence at a faster rate and led to faster elimination of infection and return to normalcy. Further prioritisation by age group amplified the gains of prioritisation by antibody status. Gains from prioritisation by antibody status were largest in settings where the proportion of the population already infected at the commencement of vaccination was 30%–60%. For a vaccine that only protects against disease and not infection, vaccine impact was reduced by half, whether this impact was measured in terms of averted infections or disease outcomes, but the relative gains from using antibody status to prioritise vaccination recipients were similar.ConclusionsMajor health and economic gains can be achieved more quickly by prioritizing those who are antibody-negative while doses of the vaccine remain in short supply.

Funder

The Biomedical Research Program and the Biostatistics, Epidemiology and Biomathematics Research Core at Weill Cornell Medicine-Qatar, Ministry of Public Health, and Hamad Medical Corporation

Publisher

BMJ

Subject

General Medicine

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