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Preprint in English | medRxiv | ID: ppmedrxiv-21266967


AimThe New Zealand government is transitioning from the Alert Level framework, which relies on government action and population level controls, to the COVID-19 Protection Framework, which relies on vaccination rates and allows for greater freedoms (for the vaccinated). As restrictions are eased, there is significant interest in understanding the relative risk of spreading COVID-19 posed by unvaccinated and vaccinated individuals. MethodsA stochastic branching process model is used to simulate the spread of COVID-19 for outbreaks seeded by unvaccinated or vaccinated individuals. The likelihood of infecting or getting infected with COVID-19 is calculated based on vaccination status. ResultsA vaccinated traveler infected with COVID-19 is 9x less likely to seed an outbreak than an unvaccinated traveler infected with COVID-19. For a vaccination rate of 50%, unvaccinated individuals are responsible for 87% of all infections whereas 3% of infections are from vaccinated to vaccinated. When normalized by population, a vaccinated individual is 6.8x more likely to be infected by an unvaccinated individual than by a vaccinated individual. For a total population vaccination rate of 78.7%, which is equivalent to the 90% vaccination target for the eligible population (over 12 years old), this means that vaccinated individuals are 1.9x more likely to be infected by an unvaccinated individual than by a vaccinated, even though there are 3.7x more vaccinated individuals in the population. ConclusionsThis work demonstrates that most new infections are caused by unvaccinated individuals. These simulations illustrate the importance of vaccination in stopping individuals from becoming infected with COVID-19 and in preventing onward transmission.

Preprint in English | medRxiv | ID: ppmedrxiv-21266721


AimThe August 2021 COVID-19 outbreak in Auckland has caused the New Zealand government to transition from an elimination strategy to suppression, which relies heavily on high vaccination rates in the population. As restrictions are eased and as COVID-19 leaks through the Auckland boundary, there is a need to understand how different levels of vaccination will impact the initial stages of COVID-19 outbreaks that are seeded around the country. MethodA stochastic branching process model is used to simulate the initial spread of a COVID-19 outbreak for different vaccination rates. ResultsHigh vaccination rates are effective at minimizing the number of infections and hospitalizations. Increasing vaccination rates from 20% (approximate value at the start of the August 2021 outbreak) to 80% (approximate proposed target) of the total population can reduce the median number of infections that occur within the first four weeks of an outbreak from 1011 to 14 (25th and 75th quantiles of 545-1602 and 2-32 for V=20% and V=80%, respectively). As the vaccination rate increases, the number of breakthrough infections (infections in fully vaccinated individuals) and hospitalizations of vaccinated individuals increases. Unvaccinated individuals, however, are 3.3x more likely to be infected with COVID-19 and 25x more likely to be hospitalized. ConclusionThis work demonstrates the importance of vaccination in protecting individuals from COVID-19, preventing high caseloads, and minimizing the number of hospitalizations and hence limiting the pressure on the healthcare system.