Targeted COVID-19 Vaccination (TAV-COVID) Considering Limited Vaccination Capacities-An Agent-Based Modeling Evaluation

被引：25

作者：

Jahn, Beate ^{[1
]}

Sroczynski, Gaby ^{[1
]}

Bicher, Martin ^{[2
,3
]}

Rippinger, Claire ^{[2
]}

Muehlberger, Nikolai ^{[1
]}

Santamaria, Julia ^{[1
]}

Urach, Christoph ^{[2
]}

Schomaker, Michael ^{[1
,4
]}

Stojkov, Igor ^{[1
]}

Schmid, Daniela ^{[5
]}

Weiss, Guenter ^{[6
]}

Wiedermann, Ursula ^{[7
]}

Redlberger-Fritz, Monika ^{[8
]}

Druml, Christiane ^{[9
]}

Kretzschmar, Mirjam ^{[10
]}

Paulke-Korinek, Maria ^{[11
]}

Ostermann, Herwig ^{[12
]}

Czasch, Caroline ^{[12
]}

Endel, Gottfried ^{[13
]}

Bock, Wolfgang ^{[14
]}

Popper, Nikolas ^{[2
,3
,15
]}

Siebert, Uwe ^{[1
,16
,17
,18
,19
]}

机构：

[1] UMIT Univ Hlth Sci Med Informat & Technol, Inst Publ Hlth Med Decis Making & Hlth Technol As, Dept Publ Hlth Hlth Serv Res & Hlth Technol Asses, Eduard Wallnoefer Zentrum 1, A-6060 Hall In Tirol, Austria

[2] Dwh GmbH, Dwh Simulat Serv, Neustiftgasse 57-59, A-1070 Vienna, Austria

[3] TU Wien, Inst Informat Syst Engn, Favoritenstr 11, A-1050 Vienna, Austria

[4] Univ Cape Town, Ctr Infect Dis Epidmiol & Res, Barnard Fuller Bldg,Anzio Rd, ZA-7935 Cape Town, South Africa

[5] UMIT Univ Hlth Sci Med Informat & Technol, Dept Publ Hlth Hlth Serv Res & Hlth Technol Asses, Div Quant Methods Publ Hlth & Hlth Serv Res, Eduard Wallnoefer Zentrum 1, A-6060 Hall In Tirol, Austria

[6] Med Univ Innsbruck, Dept Internal Med 2, Anichstr 35, A-6020 Innsbruck, Austria

[7] Med Univ Vienna, Ctr Pathophysiol Infectiol & Immunol OEL, Inst Specif Prophylaxis & Trop Med, Kinderspitalgasse 15, A-1090 Vienna, Austria

[8] Med Univ Vienna, Ctr Virol, Kinderspitalgasse 15, A-1090 Vienna, Austria

[9] Med Univ Vienna, UNESCO Chair Bioeth, Waehringerstr 25, A-1090 Vienna, Austria

[10] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands

[11] Minist Social Affairs Hlth Care & Consumer Protec, Stubenring 1, A-1010 Vienna, Austria

[12] Gesundheit Osterreich GmbH, Austrian Natl Publ Hlth Inst, Stubenring 6, A-1010 Vienna, Austria

[13] Austrian Federat Social Insurances, Kundmanngasse 21, A-1030 Vienna, Austria

[14] TU Kaiserslautern, Dept Math, Gottlieb Daimler Str 48, D-67663 Kaiserslautern, Germany

[15] Assoc Decis Support Hlth Policy & Planning, DEXHELPP, Neustiftgasse 57-59, A-1070 Vienna, Austria

[16] Harvard Med Sch, Massachusetts Gen Hosp, Inst Technol Assessment, 101 Merrimac St, Boston, MA 02114 USA

[17] Harvard Med Sch, Massachusetts Gen Hosp, Dept Radiol, 101 Merrimac St, Boston, MA 02114 USA

[18] Harvard TH Chan Sch Publ Hlth, Ctr Hlth Decis Sci, Dept Epidemiol, 718 Huntington Ave, Boston, MA 02115 USA

[19] Harvard TH Chan Sch Publ Hlth, Ctr Hlth Decis Sci, Dept Hlth Policy & Management, 718 Huntington Ave, Boston, MA 02115 USA

来源：

VACCINES | 2021年 / 9卷 / 05期

关键词：

SARS-CoV-2; COVID-19; vaccination; prioritization; vaccination strategy; optimization; decision-analytic modeling; agent-based simulation; health policy decision making; policy guidance; STRATEGIES;

D O I：

10.3390/vaccines9050434

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

(1) Background: The Austrian supply of COVID-19 vaccine is limited for now. We aim to provide evidence-based guidance to the authorities in order to minimize COVID-19-related hospitalizations and deaths in Austria. (2) Methods: We used a dynamic agent-based population model to compare different vaccination strategies targeted to the elderly (65 >= years), middle aged (45-64 years), younger (15-44 years), vulnerable (risk of severe disease due to comorbidities), and healthcare workers (HCW). First, outcomes were optimized for an initially available vaccine batch for 200,000 individuals. Second, stepwise optimization was performed deriving a prioritization sequence for 2.45 million individuals, maximizing the reduction in total hospitalizations and deaths compared to no vaccination. We considered sterilizing and non-sterilizing immunity, assuming a 70% effectiveness. (3) Results: Maximum reduction of hospitalizations and deaths was achieved by starting vaccination with the elderly and vulnerable followed by middle-aged, HCW, and younger individuals. Optimizations for vaccinating 2.45 million individuals yielded the same prioritization and avoided approximately one third of deaths and hospitalizations. Starting vaccination with HCW leads to slightly smaller reductions but maximizes occupational safety. (4) Conclusion: To minimize COVID-19-related hospitalizations and deaths, our study shows that elderly and vulnerable persons should be prioritized for vaccination until further vaccines are available.

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