Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study

Summary: Background: Countries in the World Health Organization (WHO) European Region differ in terms of the COVID-19 vaccine supply conditions. We evaluated the health and economic impact of different age-based vaccine prioritisation strategies across this demographically and socio-economically di...

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Autores principales:	Yang Liu, Frank G. Sandmann, Rosanna C. Barnard, Carl A.B. Pearson, CMMID COVID-19 Working Group, Roberta Pastore, Richard Pebody, Stefan Flasche, Mark Jit
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Vaccine policy Health economics Policy evaluation COVID-19 Europe Mathematical modelling Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/078e4f5292e84244a5b173d67b33e25e
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spelling	oai:doaj.org-article:078e4f5292e84244a5b173d67b33e25e2021-12-02T05:04:25ZOptimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study2666-776210.1016/j.lanepe.2021.100267https://doaj.org/article/078e4f5292e84244a5b173d67b33e25e2022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666776221002532https://doaj.org/toc/2666-7762Summary: Background: Countries in the World Health Organization (WHO) European Region differ in terms of the COVID-19 vaccine supply conditions. We evaluated the health and economic impact of different age-based vaccine prioritisation strategies across this demographically and socio-economically diverse region. Methods: We fitted age-specific compartmental models to the reported daily COVID-19 mortality in 2020 to inform the immunity level before vaccine roll-out. Models capture country-specific differences in population structures, contact patterns, epidemic history, life expectancy, and GDP per capita.We examined four strategies that prioritise: all adults (V+), younger (20-59 year-olds) followed by older adults (60+) (V20), older followed by younger adults (V60), and the oldest adults (75+) (V75) followed by incrementally younger age groups. We explored four roll-out scenarios (R1-4) — the slowest scenario (R1) reached 30% coverage by December 2022 and the fastest (R4) 80% by December 2021. Five decision-making metrics were summarised over 2021-22: mortality, morbidity, and losses in comorbidity-adjusted life expectancy, comorbidity- and quality-adjusted life years, and human capital. Six vaccine profiles were tested — the highest performing vaccine has 95% efficacy against both infection and disease, and the lowest 50% against diseases and 0% against infection. Findings: Of the 20 decision-making metrics and roll-out scenario combinations, the same optimal strategy applied to all countries in only one combination; V60 was more or similarly desirable than V75 in 19 combinations. Of the 38 countries with fitted models, 11-37 countries had variable optimal strategies by decision-making metrics or roll-out scenarios. There are greater benefits in prioritising older adults when roll-out is slow and when vaccine profiles are less favourable. Interpretation: The optimal age-based vaccine prioritisation strategies were sensitive to country characteristics, decision-making metrics, and roll-out speeds. A prioritisation strategy involving more age-based stages (V75) does not necessarily lead to better health and economic outcomes than targeting broad age groups (V60). Countries expecting a slow vaccine roll-out may particularly benefit from prioritising older adults. Funding: World Health Organization, Bill and Melinda Gates Foundation, the Medical Research Council (United Kingdom), the National Institute of Health Research (United Kingdom), the European Commission, the Foreign, Commonwealth and Development Office (United Kingdom), Wellcome TrustYang LiuFrank G. SandmannRosanna C. BarnardCarl A.B. Pearson, CMMID COVID-19 Working GroupRoberta PastoreRichard PebodyStefan FlascheMark JitElsevierarticleVaccine policyHealth economicsPolicy evaluationCOVID-19EuropeMathematical modellingPublic aspects of medicineRA1-1270ENThe Lancet Regional Health. Europe, Vol 12, Iss , Pp 100267- (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Vaccine policy Health economics Policy evaluation COVID-19 Europe Mathematical modelling Public aspects of medicine RA1-1270
spellingShingle	Vaccine policy Health economics Policy evaluation COVID-19 Europe Mathematical modelling Public aspects of medicine RA1-1270 Yang Liu Frank G. Sandmann Rosanna C. Barnard Carl A.B. Pearson, CMMID COVID-19 Working Group Roberta Pastore Richard Pebody Stefan Flasche Mark Jit Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study
description	Summary: Background: Countries in the World Health Organization (WHO) European Region differ in terms of the COVID-19 vaccine supply conditions. We evaluated the health and economic impact of different age-based vaccine prioritisation strategies across this demographically and socio-economically diverse region. Methods: We fitted age-specific compartmental models to the reported daily COVID-19 mortality in 2020 to inform the immunity level before vaccine roll-out. Models capture country-specific differences in population structures, contact patterns, epidemic history, life expectancy, and GDP per capita.We examined four strategies that prioritise: all adults (V+), younger (20-59 year-olds) followed by older adults (60+) (V20), older followed by younger adults (V60), and the oldest adults (75+) (V75) followed by incrementally younger age groups. We explored four roll-out scenarios (R1-4) — the slowest scenario (R1) reached 30% coverage by December 2022 and the fastest (R4) 80% by December 2021. Five decision-making metrics were summarised over 2021-22: mortality, morbidity, and losses in comorbidity-adjusted life expectancy, comorbidity- and quality-adjusted life years, and human capital. Six vaccine profiles were tested — the highest performing vaccine has 95% efficacy against both infection and disease, and the lowest 50% against diseases and 0% against infection. Findings: Of the 20 decision-making metrics and roll-out scenario combinations, the same optimal strategy applied to all countries in only one combination; V60 was more or similarly desirable than V75 in 19 combinations. Of the 38 countries with fitted models, 11-37 countries had variable optimal strategies by decision-making metrics or roll-out scenarios. There are greater benefits in prioritising older adults when roll-out is slow and when vaccine profiles are less favourable. Interpretation: The optimal age-based vaccine prioritisation strategies were sensitive to country characteristics, decision-making metrics, and roll-out speeds. A prioritisation strategy involving more age-based stages (V75) does not necessarily lead to better health and economic outcomes than targeting broad age groups (V60). Countries expecting a slow vaccine roll-out may particularly benefit from prioritising older adults. Funding: World Health Organization, Bill and Melinda Gates Foundation, the Medical Research Council (United Kingdom), the National Institute of Health Research (United Kingdom), the European Commission, the Foreign, Commonwealth and Development Office (United Kingdom), Wellcome Trust
format	article
author	Yang Liu Frank G. Sandmann Rosanna C. Barnard Carl A.B. Pearson, CMMID COVID-19 Working Group Roberta Pastore Richard Pebody Stefan Flasche Mark Jit
author_facet	Yang Liu Frank G. Sandmann Rosanna C. Barnard Carl A.B. Pearson, CMMID COVID-19 Working Group Roberta Pastore Richard Pebody Stefan Flasche Mark Jit
author_sort	Yang Liu
title	Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study
title_short	Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study
title_full	Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study
title_fullStr	Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study
title_full_unstemmed	Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study
title_sort	optimising health and economic impacts of covid-19 vaccine prioritisation strategies in the who european region: a mathematical modelling study
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/078e4f5292e84244a5b173d67b33e25e
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Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study

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