Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.
School of Medicine, University of Bristol, Bristol, UK.
Anaesthesia. 2021 May;76(5):608-616. doi: 10.1111/anae.15442. Epub 2021 Feb 11.
National (and global) vaccination provides an opportunity to control the COVID-19 pandemic, which disease suppression by societal lockdown and individual behavioural changes will not. We modelled how vaccination through the UK's vaccine priority groups impacts deaths, hospital and ICU admissions from COVID-19. We used the UK COVID-19 vaccines delivery plan and publicly available data to estimate UK population by age group and vaccination priority group, including frontline health and social care workers and individuals deemed 'extreme clinical vulnerable' or 'high risk'. Using published data on numbers and distributions of COVID-19-related hospital and ICU admissions and deaths, we modelled the impact of vaccination by age group. We then modified the model to account for hospital and ICU admission, and death among health and social care workers and the population with extreme clinical vulnerability and high risk. Our model closely matches the government's estimates for mortality after vaccination of priority groups 1-4 and groups 1-9. The model shows vaccination will have a much slower impact on hospital and ICU admissions than on deaths. The early prioritisation of healthcare staff and clinically vulnerable patients increases the impact of vaccination on admissions and also protects the healthcare service. An inflection point, when 50% of the adult population has been vaccinated - with deaths reduced by 95% and hospital admissions by 80% - may be a useful point for re-evaluating vaccine prioritisation. Our model suggests substantial reductions in hospital and ICU admissions will not occur until late March and into April 2021.
全国(和全球)接种疫苗为控制 COVID-19 大流行提供了机会,而通过社会封锁和个人行为改变来抑制疾病则无法实现这一目标。我们模拟了通过英国疫苗优先群体接种疫苗如何影响 COVID-19 的死亡、住院和 ICU 入院人数。我们使用了英国 COVID-19 疫苗接种计划和公开数据来估计按年龄组和疫苗优先组划分的英国人口,包括一线卫生和社会保健工作者以及被认为“极度临床脆弱”或“高风险”的个人。使用有关 COVID-19 相关住院和 ICU 入院和死亡人数和分布的已发表数据,我们按年龄组模拟了疫苗接种的影响。然后,我们修改了模型,以考虑卫生和社会保健工作者以及具有极度临床脆弱性和高风险的人群中的住院和 ICU 入院以及死亡人数。我们的模型与政府对优先组 1-4 和组 1-9 接种疫苗后的死亡率的估计非常吻合。该模型表明,与死亡相比,疫苗接种对住院和 ICU 入院的影响要慢得多。优先考虑医护人员和临床脆弱患者可提高疫苗接种对入院的影响,并保护医疗服务。当 50%的成年人口接种疫苗时(死亡减少 95%,住院减少 80%),可能是重新评估疫苗接种优先级的一个有用的转折点。我们的模型表明,到 2021 年 3 月下旬和 4 月,住院和 ICU 入院人数才会大幅减少。