Study of emergency supplies based dispatch in a persistent epidemic

The continued outbreak of the novel coronavirus pneumonia (COVID-19) has had a huge impact on people's lives. In the context of the ongoing epidemic and the limited distribution capacity due to the multi-regional epidemic closure, it has become an urgent reality to minimise the damage caused to people's daily lives under the epidemic and other emergencies, and to implement safe, fair and economical dispatch of emergency supplies for the epidemic area. The problem. Based on this, a mixed integer linear programming model is constructed to maximise the fairness and minimise the transportation cost of emergency material dispatch. © 2023 SPIE.

Successful prioritisation of inguinal herniotomies in children during the COVID-19 pandemic to minimise emergency presentations.

Background: The coronavirus disease 2019 (COVID-19) disrupted the delivery of elective surgery in children. We introduced guidance to mitigate this impact. By reviewing the outcomes for inguinal herniotomies, we aimed to determine if this guidance has enabled us to prevent an increase in the elective surgery wait time and therefore the need for emergency surgery for incarcerated hernias. This report aims to share our learnt lessons about responding to a crisis limiting accessibility to elective surgery. Results: We performed a retrospective review of all elective and emergency herniotomies performed between April 1 and September 30, 2019 (pre-COVID-19) and the same period in 2020 (post-COVID-19). We compared the data on wait time from referral to clinic review/elective surgery and incarceration rates. During the study period in 2019, 76 elective herniotomies were performed compared to 46 in 2020. We did not observe a simultaneous increase in emergency herniotomies in 2020 (27 [2020] vs 25 [2019], OR [95% CI] = 1.53 [0.79-2.9]; p = 0.2). The median time from referral to elective surgery in 2019 compared to 2020 did not differ (56 vs 59 days, respectively; p = 0.61). In 2020, 72% of children that required emergency surgery had not been previously referred to our service and the median age (interquartile range) at which they presented with an incarcerated hernia was 2.8 months (2.1-13.7 months). Conclusion: By adhering to local guidelines for resumption of elective activity, the pandemic did not result in children waiting longer to be seen by a surgeon for a suspected inguinal hernia. As a result, we did not perform more emergency herniotomies. Urgent prioritisation of hernias in infants, from birth up to 3 months old, was a beneficial strategy. Public health education on childhood hernias will improve outcomes. Supplementary Information: The online version contains supplementary material available at 10.1186/s43159-023-00243-1.

A sampling strategy for genome sequencing the British terrestrial arthropod fauna.

The Darwin Tree of Life (DToL) project aims to sequence and assemble high-quality genomes from all eukaryote species in Britain and Ireland, with the first phase of the project concentrating on family-level coverage plus species of particular ecological, biomedical or evolutionary interest. We summarise the processes involved in (1) assessing the UK arthropod fauna and the status of individual species on UK lists; (2) prioritising and collecting species for initial genome sequencing; (3) handling methods to ensure that high-quality genomic DNA is preserved; and (4) compiling standard operating procedures for processing specimens for genome sequencing, identification verification and voucher specimen curation. We briefly explore some lessons learned from the pilot phase of DToL and the impact of the Covid-19 pandemic.

Optimising the impact of COVID-19 vaccination on mortality and hospitalisations using an individual additive risk measuring approach based on a risk adjustment scheme.

In this population-based cohort study, billing data from German statutory health insurance (BARMER, 10% of population) are used to develop a prioritisation model for COVID-19 vaccinations based on cumulative underlying conditions. Using a morbidity-based classification system, prevalence and risks for COVID-19-related hospitalisations, ventilations and deaths are estimated. Trisomies, behavioural and developmental disorders (relative risk: 2.09), dementia and organic psychoorganic syndromes (POS) (2.23) and (metastasised) malignant neoplasms (1.99) were identified as the most important conditions for escalations of COVID-19 infection. Moreover, optimal vaccination priority schedules for participants are established on the basis of individual cumulative escalation risk and are compared to the prioritisation scheme chosen by the German Government. We estimate how many people would have already received a vaccination prior to escalation. Vaccination schedules based on individual cumulative risk are shown to be 85% faster than random schedules in preventing deaths, and as much as 57% faster than the German approach, which was based primarily on age and specific diseases. In terms of hospitalisation avoidance, the individual cumulative risk approach was 51% and 28% faster. On this basis, it is concluded that using individual cumulative risk-based vaccination schedules, healthcare systems can be relieved and escalations more optimally avoided.

Levelling up: prioritisation of global health.

Trauma has been described as "The forgotten pandemic" (Rossiter in Int Orthop 46:3-11, 2022  https://doi.org/10.1007/s00264-021055213-z ) or "The hidden pandemic" (Graham SM, Laubscher M, Lalloo DG, Harrison WJ, Maqungo S in The Surg, 20, 231-236. https://doi.org/10.1016/j.surg.2021.04.005 , 2022). If you add all deaths and disability from all contagious disease including: HIV, TB, malaria and COVID-19 these do not come close to the numbers affected annually from trauma/injury (Rossiter in Int Orthop 46:3-11, 2022; Annual deaths from the WHO Global Health Observatory (25); in: Preventing Injuries and Violence: A Guide for Ministries of Health, WHO, Geneva, 26). Prior to the present pandemic contagious disease received approximately 35% of global healthcare spending, whilst trauma received just 1% (Wesson et al. in Health Policy Plan 29:795-808, 2014). The global healthcare spending on contagious disease in the last two years has doubled and that of trauma has proportionately decreased, highlighting the significant issue of prioritisation of healthcare globally. Trauma is the greatest cause of mortality and morbidity in the 5 to 30 age group (Wesson et al. in Health Policy Plan 29:795-808, 2014). Most of the world lives in a country where the majority of the population are under the age of 35, the working population, who are disproportionately affected by trauma. Investment into trauma/injury could dramatically improve the GDP of that country and the situation of the population ( https://www.thinkglobalhealth.org/article/golden-hour-critical-time-between-life-and-death ). It is also estimated that 5 billion people globally lack "Available Accessible Acceptable & Quality" (the AAAQ framework) Surgical Obstetric Trauma & Anaesthetic (SOTA) (Meara JG et al. in Lancet, 386(9993):569-624. https://doi.org/10.1016/S0140-6736(15)60160-X , 2015). Access to this care is an agreed human right (Price R, Makasa E, Hollands M in World J Surg, 39(9):2115-25. https://doi.org/10.1007/s00268-015-3153-y . PMID: 26239773, 2015). It forms part of the 17 Millennium Sustainable Development Goals from the United Nations to be achieved within 20 years ( https://sdgs.un.org/goals#goals ). By 2014, it was recognised that AAAQ SOTA care was not going to be achieved within the next 5 years and so the G4 Alliance was born with the aim of achieving this by 2030 ( https://www.theg4alliance.org ).

Research priorities for maternal and perinatal health clinical trials and methods used to identify them: A systematic review.

OBJECTIVE: Research prioritisation helps to target research resources to the most pressing health and healthcare needs of a population. This systematic review aimed to report research priorities in maternal and perinatal health and to assess the methods that were used to identify them. METHODS: A systematic review was undertaken. Projects that aimed to identify research priorities that were considered to be amenable to clinical trials research were eligible for inclusion. The search, limited to the last decade and publications in English, included MEDLINE, EMBASE, CINHAL, relevant Cochrane priority lists, Cochrane Priority Setting Methods Group homepage, James Lind Alliance homepage, Joanna Brigg's register, PROSPERO register, reference lists of all included articles, grey literature, and the websites of relevant professional bodies, until 13 October 2020. The methods used for prioritisation were appraised using the Reporting Guideline for Priority Setting of Health Research (REPRISE). FINDINGS: From the 62 included projects, 757 research priorities of relevance to maternal and perinatal health were identified. The most common priorities related to healthcare systems and services, pregnancy care and complications, and newborn care and complications. The least common priorities related to preconception and postpartum health, maternal mental health, contraception and pregnancy termination, and fetal medicine and surveillance. The most commonly used prioritisation methods were Delphi (20, 32%), Child Health Nutrition Research Initiative (17, 27%) and the James Lind Alliance (10, 16%). The fourteen projects (23%) that reported on at least 80% of the items included in the REPRISE guideline all used an established research prioritisation method. CONCLUSIONS: There are a large number of diverse research priorities in maternal and perinatal health that are amenable to future clinical trials research. These have been identified by a variety of research prioritisation methods.

Vaccination as an Equaliser? Evaluating COVID-19 Vaccine Prioritisation and Compensation.

This article assesses the equity of COVID-19 vaccination programmes in three jurisdictions that have historically taken different approaches to the institutionalisation of equity considerations. The Sars-Cov-2 pandemic has thrown into sharp relief persistent societal inequalities and has added novel dimensions to these problems. Certain groups have proved particularly vulnerable, both in terms of infection risk and severity as well as the accompanying social fallout. Against this background the implementation of 'objective' vaccination programmes may seem like a great leveller, addressing the disparate risks that are tied to social determinants of health and the pandemic behemoth. However, implementing vaccination programmes in an equitable manner is itself essential for the realisation of such a vision. This article undertakes a comparative analysis of the English, Italian, and American jurisdictions and critically assesses two aspects of their vaccination frameworks: (i) the prioritisation of groups for vaccination and (ii) the nature of public compensation schemes for those who have suffered vaccine-related injuries. It examines whether and to what extent these measures address the inequalities raised by COVID-19 and the role of the law in this pursuit.

Minimising population health loss in times of scarce surgical capacity: a modelling study for surgical procedures performed in nonacademic hospitals.

BACKGROUND: The burden of the COVID-19 pandemic resulted in a reduction of available health care capacity for regular care. To guide prioritisation of semielective surgery in times of scarcity, we previously developed a decision model to quantify the expected health loss due to delay of surgery, in an academic hospital setting. The aim of this study is to validate our decision model in a nonacademic setting and include additional elective surgical procedures. METHODS: In this study, we used the previously published three-state cohort state-transition model, to evaluate the health effects of surgery postponement for 28 surgical procedures commonly performed in nonacademic hospitals. Scientific literature and national registries yielded nearly all input parameters, except for the quality of life (QoL) estimates which were obtained from experts using the Delphi method. Two expert panels, one from a single nonacademic hospital and one from different nonacademic hospitals in the Netherlands, were invited to estimate QoL weights. We compared estimated model results (disability adjusted life years (DALY)/month of surgical delay) based on the QoL estimates from the two panels by calculating the mean difference and the correlation between the ranks of the different surgical procedures. The eventual model was based on the combined QoL estimates from both panels. RESULTS: Pacemaker implantation was associated with the most DALY/month of surgical delay (0.054 DALY/month, 95% CI: 0.025-0.103) and hemithyreoidectomy with the least DALY/month (0.006 DALY/month, 95% CI: 0.002-0.009). The overall mean difference of QoL estimates between the two panels was 0.005 (95% CI -0.014-0.004). The correlation between ranks was 0.983 (p < 0.001). CONCLUSIONS: Our study provides an overview of incurred health loss due to surgical delay for surgeries frequently performed in nonacademic hospitals. The quality of life estimates currently used in our model are robust and validate towards a different group of experts. These results enrich our earlier published results on academic surgeries and contribute to prioritising a more complete set of surgeries.

CZECH EXPERT STATEMENTS ON PATIENT PRIORITISATION IN THE COVID-19 PANDEMIC IN INTERNATIONAL COMPARISON

In November 2020, facing the increasing second wave of the pandemic, several professional societies of the Czech Medical Association of J. E. Purkyně issued a statement on the allocation of scarce health resources. The Statement has since been criticised at times as too legalistic and vague. However, the positive Czech law is rather strict in determining what criteria can be used for patient prioritisation and fails to foresee possible nationwide crises when the standard rules might be difficult to comply with. Another expert document on patient prioritisation was issued by a team from the Academy of Sciences of the Czech Republic. The two documents are very different in their approach: while the former aims at providing legal certainty, the latter predominantly uses ethical arguments. The paper analyses both statements and provides a comparison with selected guidelines from other countries as well as international law requirements. © 2021, Czech Society of International Law. All rights reserved.

Prioritising barriers of online teaching during COVID-19 from teachers' perspective: using the analytic hierarchy process

Online teaching is no longer a choice but is an essential requirement for teachers due to the outbreak of global pandemic COVID-19. In India, lockdown conditions are still in force, and educational institutions are closed until further notice. Teachers are conducting online sessions from their homes, so it is important to identify the barriers encountered by teachers in online teaching. The purpose of this paper is to identify and prioritise the barriers faced by teachers in online teaching during COVID-19 pandemic in the HEIs of India. AHP approach is employed to prioritise the barriers encountered by teachers in online teaching during COVID-19 pandemic. The data was collected from 27 teachers working in various universities of Uttarakhand, India. These findings indicate that 'lack of institutional support' is the main barrier followed by home environment settings, technical issues, teachers' readiness, and students' readiness in online teaching during COVID-19 pandemic in India.

Systemising triage: COVID-19 guidelines and their underlying theories of distributive justice.

The COVID-19 pandemic has been overwhelming public health-care systems around the world. With demand exceeding the availability of medical resources in several regions, hospitals have been forced to invoke triage. To ensure that this difficult task proceeds in a fair and organised manner, governments scrambled experts to draft triage guidelines under enormous time pressure. Although there are similarities between the documents, they vary considerably in how much weight their respective authors place on the different criteria that they propose. Since most of the recommendations do not come with ethical justifications, analysing them requires that one traces back these criteria to their underlying theories of distributive justice. In the literature, COVID-19 triage has been portrayed as a value conflict solely between utilitarian and egalitarian elements. While these two accounts are indeed the main antipodes, I shall show that in fact all four classic theories of distributive justice are involved: utilitarianism, egalitarianism, libertarianism, and communitarianism. Detecting these in the documents and classifying the suggested criteria accordingly enables one to understand the balancing between the different approaches to distributive justice-which is crucial for both managing the current pandemic and in preparation for the next global health crisis.

Recognising Sepsis as a Health Priority in Sub-Saharan African Country: Learning Lessons from Engagement with Gabon's Health Policy Stakeholders.

Sepsis has been recognised as a global health priority by the United Nations World Health Assembly, which adopted a resolution in 2017 to improve sepsis prevention, diagnosis, and management globally. This study investigated how sepsis is prioritised in Gabon. From May to November 2021, we conducted a qualitative study in healthcare stakeholders at the local, regional, and national levels. Stakeholders included the Ministry of Health (MOH), ethics/regulatory bodies, research institutions, academic institutions, referral hospitals, international funders, and the media. Twenty-three multisectoral stakeholders were interviewed. Respondents indicated that sepsis is not yet prioritised in Gabon due to the lack of evidence of its burden. They also suggest that the researchers should focus on linkages between sepsis and the countries' existing health sector priorities to accelerate sepsis prioritisation in health policy. Stakeholder awareness and engagement might be accelerated by involving the media in the generation of communication strategies around sepsis awareness and prioritisation. There is a need for local, regional and national evidence to be generated by researchers and taken up by policymakers, focusing on linkages between sepsis and a country's existing health sector priorities. The MOH should set sepsis reporting structures and develop appropriate sepsis guidelines for identification, management, and prevention.

Prioritisation Assessment and Robust Predictive System for Medical Equipment: A Comprehensive Strategic Maintenance Management.

The advancement of technology in medical equipment has significantly improved healthcare services. However, failures in upkeeping reliability, availability, and safety affect the healthcare services quality and significant impact can be observed in operations' expenses. The effective and comprehensive medical equipment assessment and monitoring throughout the maintenance phase of the asset life cycle can enhance the equipment reliability, availability, and safety. The study aims to develop the prioritisation assessment and predictive systems that measure the priority of medical equipment's preventive maintenance, corrective maintenance, and replacement programmes. The proposed predictive model is constructed by analysing features of 13,352 medical equipment used in public healthcare clinics in Malaysia. The proposed system comprises three stages: prioritisation analysis, model training, and predictive model development. In this study, we proposed 16 combinations of novel features to be used for prioritisation assessment and prediction of preventive maintenance, corrective maintenance, and replacement programme. The modified k-Means algorithm is proposed during the prioritisation analysis to automatically distinguish raw data into three main clusters of prioritisation assessment. Subsequently, these clusters are fed into and tested with six machine learning algorithms for the predictive prioritisation system. The best predictive models for medical equipment's preventive maintenance, corrective maintenance, and replacement programmes are selected among the tested machine learning algorithms. Findings indicate that the Support Vector Machine performs the best in preventive maintenance and replacement programme prioritisation predictive systems with the highest accuracy of 99.42 and 99.80%, respectively. Meanwhile, K-Nearest Neighbour yielded the highest accuracy in corrective maintenance prioritisation predictive systems with 98.93%. Based on the promising results, clinical engineers and healthcare providers can widely adopt the proposed prioritisation assessment and predictive systems in managing expenses, reporting, scheduling, materials, and workforce.

Impact of the COVID-19 pandemic on orthognathic patients: What have we learned?

Due to the COVID-19 pandemic orthognathic surgery was suspended in the UK. The effect this had on patients, to date, is unknown. A multi-centre, cross-sectional survey was conducted in the UK to investigate the health-related impact on patients on the orthognathic surgery pathway, including those on the waiting list for surgery. A structured questionnaire was designed to explore the impact of the pandemic on patients whose orthognathic treatment was temporarily cancelled. Ninety-five questionnaires were returned giving a response rate of 65%. When asked if the delay due to the pandemic had caused emotional distress, 63% (51/81) agreed. During the pandemic respondents experienced more distress in relation to dental appearance (60%, 51/83), self-confidence (52% 50/83), facial appearance (53%, 44/83), and ability to eat and chew (59%, 50/83). One hundred percent of patients would have appliances fitted or their appliances adjusted during the pandemic, and 93% stated that they would attend for surgery if they were offered this during the pandemic. In conclusion, patients appear to have experienced emotional distress in relation to the delay with their orthognathic treatment. They should be given greater priority during the remobilisation of elective surgery and should have access to ongoing psychological support when delays affect their treatment. The 'surgery-first' approach may be considered for suitable patients to minimise the duration of the treatment journey.

Isolation, Uncertainty and Treatment Delays: Parents' Experiences of Having a Baby with Cleft Lip/Palate During the Covid-19 Pandemic.

OBJECTIVES: Previous literature finds that having a child with a cleft lip and/or palate (CL/P) may pose social and emotional challenges for parents. For parents of children born during the Covid-19 pandemic, such challenges may be heightened. Further, novel demands brought about by the pandemic could have caused additional hardships. The aim of this study was to describe the impact of the pandemic on new parents through qualitative exploration of their experiences. DESIGN: Semi-structured interviews were conducted with 14 parents of children born in the United Kingdom with CL/P between January and June 2020, around the start of the pandemic. Data were analysed using inductive thematic analysis. RESULTS: Three themes, with sub-themes, were identified. The first theme, "Changes to Healthcare: The Impact of Restrictions and Reduced Contact", discussed the impact of the pandemic on perinatal care, the care received from the specialist CL/P teams, and parents' experiences of virtual consultations. The second theme, "Family Functioning During the Pandemic", covered parental anxiety, fathers' experiences, and social support. The third theme, "Surgical Prioritisation: Delays and Uncertainty", addressed changes to surgical protocols, coping with uncertainty, complications associated with delayed surgery, and how parents created positive meaning from this period. CONCLUSIONS: A range of increased and additional psychosocial impacts for parents were identified, along with several coping strategies, utilization of social support, and the positive aspects of their experiences. As the pandemic continues, close monitoring of families affected by CL/P remains imperative, particularly for those at risk of emotional distress.

The Global Impact of COVID-19 on the Care of People With Endometriosis.

Endometriosis is a chronic condition affecting ~10% of women globally. Little is known about the impact of the coronavirus disease 2019 (COVID-19) pandemic on their care. This brief report is aimed to explore the impact of COVID-19 on the care of people with endometriosis around the world, their priorities in relation to their clinical care during and coming out of the pandemic, and whether they believed that endometriosis makes them more vulnerable to COVID-19. An internet-based survey collected data in five languages between May 11, 2020, and June 8, 2020. Only participants with a surgical or radiological diagnosis of endometriosis aged 18 years or over were included. A total of 6,729 eligible respondents completed the survey with 80.7% [95% CI (79.7, 81.6)] reporting a negative impact on their care. This included difficulties obtaining medication (20.3%), cancelled/postponed gynaecology appointments (50.0%), and cancelled/postponed procedures (37.2%). More than half worried that their endometrioses make them more vulnerable to COVID-19 [54.2%; 95% CI (53.0, 55.4)]. The top three priorities were remarkably consistent around the world: contact with gynaecologists, knowing when procedures would be performed, and support with mental health (20.3% prioritising this aspect during the pandemic and 13.0% as restrictions begin to ease). This study shows the substantial impact the COVID-19 pandemic has had on people with endometriosis and describes how they would like care prioritised moving forwards. The findings regarding significant support needs for mental health add further weight to the growing recognition of attending to such issues as part of good patient-centred care.

Strategies for vaccine-product innovation: Creating an enabling environment for product development to uptake in low- and middle-income countries.

Vaccine-product innovations that address barriers to immunization are urgently needed to achieve equitable vaccine coverage, as articulated in the new Immunization Agenda 2030 and the Gavi 5.0 strategy. In 2020, the Vaccine Innovation Prioritisation Strategy (VIPS) prioritized three innovations, namely microarray patches (MAPs), heat-stable and controlled-temperature chain (CTC) enabled liquid vaccine formulations and barcodes on primary packaging. These innovations were prioritized based on the priority immunization barriers that they may help overcome in resource constrained contexts, as well as by considering their potential impact on health, coverage and equity, safety, economic costs and their technical readiness and commercial feasibility. VIPS is now working to accelerate the development and lay the foundation for future uptake of the three priority vaccine-product innovations, with the long term-goal to ensure equitable vaccine coverage and increased impact of vaccines in low- and middle- income countries. To inform our strategic planning, we analyzed four commercially available vaccine product-innovations and conducted interviews with individuals from 17 immunization organizations, and/or independent immunization experts. The findings are synthesized into an 'innovation conundrum' that describes the challenges encountered in developing vaccine-product innovations and a vaccine-product innovation 'theory of change', which highlights actions that should be undertaken in parallel to product development to incentivize sustainable investment and prepare the pathway for uptake and impact.

The Value of Quantitative Faecal Immunochemical Testing as a Prioritisation Tool for the Endoscopic Investigation of Patients With Iron Deficiency.

Difficulty in providing endoscopy for patients with iron deficiency anaemia (IDA) during the COVID-19 pandemic has highlighted the requirement for a prioritisation tool. We aimed to test the validity of qFIT as a prioritisation tool in patients with iron deficiency and its ability to identify patients with advanced neoplastic lesions (ANLs). Data collected from patients referred with biochemically proven iron deficiency (ferritin ≤ 15 µg/L) and synchronous qFIT who underwent full gastrointestinal investigation within NHS Greater Glasgow and Clyde was analysed retrospectively. Patients who did not undergo full investigation, defined as gastroscopy and colonoscopy or CT colonography, were excluded. ANLs were defined as defined as upper GI cancer, colorectal adenoma ≥ 1 cm or colorectal cancer. Area under the curve (AUC) analysis was performed on qFIT results and outcome, defined as the presence of an ANL. AUC analysis guided cut-off scores for qFIT. Patients with a qFIT of <10, 10-200, >200, were allocated a score of 1, 2, and 3, respectively. A total of 575 patients met criteria for inclusion into the study. Overall, qFIT results strongly predicted the presence of ANLs (AUC 0.87, CI 0.81-0.92; P < 0.001). The prevalence of ANLs in patients with scores 1-3 was 1.2, 13.5, and 38.9% respectfully. When controlled for other significant variables, patients with a higher qFIT score were statistically more likely to have an ANL (qFIT score = 2; OR 12.8; P < 0.001, qFIT score = 3, OR 50.0; P < 0.001). A negative qFIT had a high NPV for the presence of ANLs (98.8%, CI 97.0-99.5%). These results strongly suggest that qFIT has validity as a prioritisation tool in patients with iron deficiency; both allowing for a more informed decision of investigation of patients with very low risk of malignancy, and in identifying higher risk patients who may benefit from more urgent endoscopy.

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

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.