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实现美国 COVID-19 疫苗衍生群体免疫阈值

Toward Achieving a Vaccine-Derived Herd Immunity Threshold for COVID-19 in the U.S.

机构信息

School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, United States.

Department of Mathematics and Applied Mathematics, University of Pretoria, Pretoria, South Africa.

出版信息

Front Public Health. 2021 Jul 23;9:709369. doi: 10.3389/fpubh.2021.709369. eCollection 2021.

Abstract

A novel coronavirus emerged in December of 2019 (COVID-19), causing a pandemic that inflicted unprecedented public health and economic burden in all nooks and corners of the world. Although the control of COVID-19 largely focused on the use of basic public health measures (primarily based on using non-pharmaceutical interventions, such as quarantine, isolation, social-distancing, face mask usage, and community lockdowns) initially, three safe and highly-effective vaccines (by AstraZeneca Inc., Moderna Inc., and Pfizer Inc.), were approved for use in humans in December 2020. We present a new mathematical model for assessing the population-level impact of these vaccines on curtailing the burden of COVID-19. The model stratifies the total population into two subgroups, based on whether or not they habitually wear face mask in public. The resulting multigroup model, which takes the form of a deterministic system of nonlinear differential equations, is fitted and parameterized using COVID-19 cumulative mortality data for the third wave of the COVID-19 pandemic in the United States. Conditions for the asymptotic stability of the associated disease-free equilibrium, as well as an expression for the vaccine-derived herd immunity threshold, are rigorously derived. Numerical simulations of the model show that the size of the initial proportion of individuals in the mask-wearing group, together with positive change in behavior from the non-mask wearing group (as well as those in the mask-wearing group, who do not abandon their mask-wearing habit) play a crucial role in effectively curtailing the COVID-19 pandemic in the United States. This study further shows that the prospect of achieving vaccine-derived herd immunity (required for COVID-19 elimination) in the U.S., using the Pfizer or Moderna vaccine, is quite promising. In particular, our study shows that herd immunity can be achieved in the U.S. if at least 60% of the population are fully vaccinated. Furthermore, the prospect of eliminating the pandemic in the U.S. in the year 2021 is significantly enhanced if the vaccination program is complemented with non-pharmaceutical interventions at moderate increased levels of compliance (in relation to their baseline compliance). The study further suggests that, while the waning of natural and vaccine-derived immunity against COVID-19 induces only a marginal increase in the burden and projected time-to-elimination of the pandemic, adding the impacts of therapeutic benefits of the vaccines into the model resulted in a dramatic reduction in the burden and time-to-elimination of the pandemic.

摘要

一种新型冠状病毒于 2019 年 12 月出现(COVID-19),导致了一场大流行,给世界各个角落带来了前所未有的公共卫生和经济负担。尽管 COVID-19 的控制最初主要集中在使用基本公共卫生措施(主要基于使用非药物干预措施,如隔离、隔离、社会距离、戴口罩和社区封锁),但 2020 年 12 月,三种安全有效的疫苗(由阿斯利康公司、莫德纳公司和辉瑞公司生产)获准在人类中使用。我们提出了一种新的数学模型,用于评估这些疫苗对减轻 COVID-19 负担的人群水平影响。该模型根据人们是否习惯在公共场合戴口罩将总人口分为两个亚组。由此产生的多组模型采用非线性微分方程的确定性系统形式,使用美国 COVID-19 大流行第三波的 COVID-19 累积死亡率数据进行拟合和参数化。严格推导出相关无病平衡点的渐近稳定性条件,以及疫苗衍生的群体免疫阈值的表达式。模型的数值模拟表明,戴口罩组初始比例的大小,以及从不戴口罩组(以及戴口罩组中那些不放弃戴口罩习惯的人)的行为积极变化,对于有效控制美国的 COVID-19 大流行起着至关重要的作用。这项研究进一步表明,使用辉瑞或莫德纳疫苗在美国实现疫苗衍生的群体免疫(消除 COVID-19 所需)的前景非常乐观。特别是,如果至少有 60%的人口完全接种疫苗,我们的研究表明,美国可以实现群体免疫。此外,如果疫苗接种计划与适度增加的合规水平(相对于基线合规水平)的非药物干预措施相配合,美国消除大流行的前景将大大增强。该研究进一步表明,尽管 COVID-19 自然和疫苗衍生免疫力的减弱只会导致大流行的负担和预计消除时间略有增加,但将疫苗治疗益处的影响纳入模型会导致大流行的负担和消除时间大幅减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/296e/8343072/c85fe1600e32/fpubh-09-709369-g0001.jpg

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