Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, MA, USA.
Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, 02115 Boston, MA, USA; Department of Mathematics & Statistics, Vassar College, 12604 Poughkeepsie, NY, USA.
Vaccine. 2023 Mar 10;41(11):1864-1874. doi: 10.1016/j.vaccine.2022.12.053. Epub 2023 Jan 23.
Vaccine allocation decisions during emerging pandemics have proven to be challenging due to competing ethical, practical, and political considerations. Complicating decision making, policy makers need to consider vaccine allocation strategies that balance needs both within and between populations. When vaccine stockpiles are limited, doses should be allocated in locations to maximize their impact. Using a susceptible-exposed-infectious-recovered (SEIR) model we examine optimal vaccine allocation decisions across two populations considering the impact of characteristics of the population (e.g., size, underlying immunity, heterogeneous risk structure, interaction), vaccine (e.g., vaccine efficacy), pathogen (e.g., transmissibility), and delivery (e.g., varying speed and timing of rollout). Across a wide range of characteristics considered, we find that vaccine allocation proportional to population size (i.e., pro-rata allocation) performs either better or comparably to nonproportional allocation strategies in minimizing the cumulative number of infections. These results may argue in favor of sharing of vaccines between locations in the context of an epidemic caused by an emerging pathogen, where many epidemiologic characteristics may not be known.
在新发传染病大流行期间，疫苗分配决策因相互竞争的伦理、实际和政治考虑而变得极具挑战性。由于决策者需要考虑在人群内部和人群之间平衡需求的疫苗分配策略，这使得决策变得更加复杂。当疫苗库存有限时，应在能够最大程度发挥其影响的地方分配疫苗剂量。我们使用易感染-暴露-感染-恢复（SEIR）模型，在考虑人口特征（例如，规模、基础免疫力、异质风险结构、相互作用）、疫苗（例如，疫苗效力）、病原体（例如，传染性）和疫苗接种（例如，推出速度和时间的差异）的影响的情况下，研究了两个群体之间的最佳疫苗分配决策。在考虑的各种特征中，我们发现，疫苗分配与人口规模成正比（即按比例分配），在最大限度地减少累积感染人数方面，其表现要么优于非比例分配策略，要么与非比例分配策略相当。这些结果可能支持在新兴病原体引发的传染病流行期间，在多个地点之间共享疫苗，因为在这种情况下，许多流行病学特征可能并不清楚。
