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1.
PLoS One ; 17(2): e0263155, 2022.
Article in English | MEDLINE | ID: covidwho-1793533

ABSTRACT

With limited availability of vaccines, an efficient use of the limited supply of vaccines in order to achieve herd immunity will be an important tool to combat the wide-spread prevalence of COVID-19. Here, we compare a selection of strategies for vaccine distribution, including a novel targeted vaccination approach (EHR) that provides a noticeable increase in vaccine impact on disease spread compared to age-prioritized and random selection vaccination schemes. Using high-fidelity individual-based computer simulations with Oslo, Norway as an example, we find that for a community reproductive number in a setting where the base pre-vaccination reproduction number R = 2.1 without population immunity, the EHR method reaches herd immunity at 48% of the population vaccinated with 90% efficiency, whereas the common age-prioritized approach needs 89%, and a population-wide random selection approach requires 61%. We find that age-based strategies have a substantially weaker impact on epidemic spread and struggle to achieve herd immunity under the majority of conditions. Furthermore, the vaccination of minors is essential to achieving herd immunity, even for ideal vaccines providing 100% protection.


Subject(s)
COVID-19 Vaccines/supply & distribution , COVID-19/prevention & control , COVID-19/genetics , COVID-19/immunology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/pharmacology , Epidemics , Humans , Immunity, Herd/immunology , Models, Theoretical , SARS-CoV-2/immunology , SARS-CoV-2/pathogenicity , Vaccination , Vaccines
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J Med Virol ; 94(4): 1336-1349, 2022 04.
Article in English | MEDLINE | ID: covidwho-1718399

ABSTRACT

The entire world has been suffering from the coronavirus disease 2019 (COVID-19) pandemic since March 11, 2020. More than a year later, the COVID-19 vaccination brought hope to control this viral pandemic. Here, we review the unknowns of the COVID-19 vaccination, such as its longevity, asymptomatic spread, long-term side effects, and its efficacy on immunocompromised patients. In addition, we discuss challenges associated with the COVID-19 vaccination, such as the global access and distribution of vaccine doses, adherence to hygiene guidelines after vaccination, the emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, and vaccine resistance. Despite all these challenges and the fact that the end of the COVID-19 pandemic is still unclear, vaccines have brought great hope for the world, with several reports indicating a significant decline in the risk of COVID19-related infection and hospitalizations.


Subject(s)
COVID-19/prevention & control , SARS-CoV-2/immunology , Vaccination , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , COVID-19 Vaccines/immunology , COVID-19 Vaccines/supply & distribution , Global Health , Humans , Immunocompromised Host , Mutation , SARS-CoV-2/genetics , Vaccination/adverse effects , Vaccination/psychology
12.
Am J Public Health ; 112(3): 393-396, 2022 03.
Article in English | MEDLINE | ID: covidwho-1703908

ABSTRACT

Refugee and immigrant populations are extremely vulnerable to the consequences of the COVID-19 pandemic. COVID-19 vaccination is a critical tool in mitigating these consequences, but these same communities often lack access to COVID-19 vaccines. We describe the efforts of a community-based primary care clinic in Clarkston, Georgia to provide access to COVID-19 vaccines in a culturally sensitive manner to address this health disparity and vaccine hesitancy.


Subject(s)
COVID-19 Vaccines/supply & distribution , COVID-19/prevention & control , Emigrants and Immigrants , Immunization Programs/organization & administration , Refugees , COVID-19/ethnology , Cultural Competency , Georgia/epidemiology , Humans , Pandemics , SARS-CoV-2 , Trust
13.
Proc Natl Acad Sci U S A ; 119(8)2022 02 22.
Article in English | MEDLINE | ID: covidwho-1671753

ABSTRACT

Due to the enormous economic, health, and social costs of the COVID-19 pandemic, there are high expected social returns to investing in parallel in multiple approaches to accelerating vaccination. We argue there are high expected social returns to investigating the scope for lowering the dosage of some COVID-19 vaccines. While existing evidence is not dispositive, available clinical data on the immunogenicity of lower doses combined with evidence of a high correlation between neutralizing antibody response and vaccine efficacy suggests that half or even quarter doses of some vaccines could generate high levels of protection, particularly against severe disease and death, while potentially expanding supply by 450 million to 1.55 billion doses per month, based on supply projections for 2021. An epidemiological model suggests that, even if fractional doses are less effective than standard doses, vaccinating more people faster could substantially reduce total infections and deaths. The costs of further testing alternative doses are much lower than the expected public health and economic benefits. However, commercial incentives to generate evidence on fractional dosing are weak, suggesting that testing may not occur without public investment. Governments could support either experimental or observational evaluations of fractional dosing, for either primary or booster shots. Discussions with researchers and government officials in multiple countries where vaccines are scarce suggests strong interest in these approaches.


Subject(s)
COVID-19 Vaccines/supply & distribution , COVID-19/prevention & control , Immunization, Secondary/methods , Models, Statistical , Vaccination/methods , COVID-19/immunology , COVID-19/mortality , COVID-19/virology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/economics , Developed Countries , Developing Countries , Drug Administration Schedule , Humans , Immunization, Secondary/economics , Off-Label Use , SARS-CoV-2/drug effects , SARS-CoV-2/immunology , SARS-CoV-2/pathogenicity , Survival Analysis , Vaccination/economics
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