Sustaining effective COVID-19 control in Malaysia through large-scale vaccination

Introduction: As of 3rd June 2021, Malaysia is experiencing a resurgence of COVID-19 cases. In response, the federal government has implemented various non-pharmaceutical interventions (NPIs) under a series of Movement Control Orders and, more recently, a vaccination campaign to regain epidemic cont...

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Autores principales:	Pavithra Jayasundara, Kalaiarasu M. Peariasamy, Kian Boon Law, Ku Nurhasni Ku Abd Rahim, Sit Wai Lee, Izzuna Mudla M. Ghazali, Milinda Abayawardana, Linh-Vi Le, Rukun K.S. Khalaf, Karina Razali, Xuan Le, Zhuo Lin Chong, Emma S. McBryde, Michael T. Meehan, Jamie M. Caldwell, Romain Ragonnet, James M. Trauer
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	COVID-19 Vaccination Variants of concern Mathematical modelling Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/e6d1e6283fdc488baa93bcfb0c0fe654
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spelling	oai:doaj.org-article:e6d1e6283fdc488baa93bcfb0c0fe6542021-11-04T04:27:38ZSustaining effective COVID-19 control in Malaysia through large-scale vaccination1755-436510.1016/j.epidem.2021.100517https://doaj.org/article/e6d1e6283fdc488baa93bcfb0c0fe6542021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1755436521000633https://doaj.org/toc/1755-4365Introduction: As of 3rd June 2021, Malaysia is experiencing a resurgence of COVID-19 cases. In response, the federal government has implemented various non-pharmaceutical interventions (NPIs) under a series of Movement Control Orders and, more recently, a vaccination campaign to regain epidemic control. In this study, we assessed the potential for the vaccination campaign to control the epidemic in Malaysia and four high-burden regions of interest, under various public health response scenarios. Methods: A modified susceptible-exposed-infectious-recovered compartmental model was developed that included two sequential incubation and infectious periods, with stratification by clinical state. The model was further stratified by age and incorporated population mobility to capture NPIs and micro-distancing (behaviour changes not captured through population mobility). Emerging variants of concern (VoC) were included as an additional strain competing with the existing wild-type strain. Several scenarios that included different vaccination strategies (i.e. vaccines that reduce disease severity and/or prevent infection, vaccination coverage) and mobility restrictions were implemented. Results: The national model and the regional models all fit well to notification data but underestimated ICU occupancy and deaths in recent weeks, which may be attributable to increased severity of VoC or saturation of case detection. However, the true case detection proportion showed wide credible intervals, highlighting incomplete understanding of the true epidemic size. The scenario projections suggested that under current vaccination rates complete relaxation of all NPIs would trigger a major epidemic. The results emphasise the importance of micro-distancing, maintaining mobility restrictions during vaccination roll-out and accelerating the pace of vaccination for future control. Malaysia is particularly susceptible to a major COVID-19 resurgence resulting from its limited population immunity due to the country’s historical success in maintaining control throughout much of 2020.Pavithra JayasundaraKalaiarasu M. PeariasamyKian Boon LawKu Nurhasni Ku Abd RahimSit Wai LeeIzzuna Mudla M. GhazaliMilinda AbayawardanaLinh-Vi LeRukun K.S. KhalafKarina RazaliXuan LeZhuo Lin ChongEmma S. McBrydeMichael T. MeehanJamie M. CaldwellRomain RagonnetJames M. TrauerElsevierarticleCOVID-19VaccinationVariants of concernMathematical modellingInfectious and parasitic diseasesRC109-216ENEpidemics, Vol 37, Iss , Pp 100517- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 Vaccination Variants of concern Mathematical modelling Infectious and parasitic diseases RC109-216
spellingShingle	COVID-19 Vaccination Variants of concern Mathematical modelling Infectious and parasitic diseases RC109-216 Pavithra Jayasundara Kalaiarasu M. Peariasamy Kian Boon Law Ku Nurhasni Ku Abd Rahim Sit Wai Lee Izzuna Mudla M. Ghazali Milinda Abayawardana Linh-Vi Le Rukun K.S. Khalaf Karina Razali Xuan Le Zhuo Lin Chong Emma S. McBryde Michael T. Meehan Jamie M. Caldwell Romain Ragonnet James M. Trauer Sustaining effective COVID-19 control in Malaysia through large-scale vaccination
description	Introduction: As of 3rd June 2021, Malaysia is experiencing a resurgence of COVID-19 cases. In response, the federal government has implemented various non-pharmaceutical interventions (NPIs) under a series of Movement Control Orders and, more recently, a vaccination campaign to regain epidemic control. In this study, we assessed the potential for the vaccination campaign to control the epidemic in Malaysia and four high-burden regions of interest, under various public health response scenarios. Methods: A modified susceptible-exposed-infectious-recovered compartmental model was developed that included two sequential incubation and infectious periods, with stratification by clinical state. The model was further stratified by age and incorporated population mobility to capture NPIs and micro-distancing (behaviour changes not captured through population mobility). Emerging variants of concern (VoC) were included as an additional strain competing with the existing wild-type strain. Several scenarios that included different vaccination strategies (i.e. vaccines that reduce disease severity and/or prevent infection, vaccination coverage) and mobility restrictions were implemented. Results: The national model and the regional models all fit well to notification data but underestimated ICU occupancy and deaths in recent weeks, which may be attributable to increased severity of VoC or saturation of case detection. However, the true case detection proportion showed wide credible intervals, highlighting incomplete understanding of the true epidemic size. The scenario projections suggested that under current vaccination rates complete relaxation of all NPIs would trigger a major epidemic. The results emphasise the importance of micro-distancing, maintaining mobility restrictions during vaccination roll-out and accelerating the pace of vaccination for future control. Malaysia is particularly susceptible to a major COVID-19 resurgence resulting from its limited population immunity due to the country’s historical success in maintaining control throughout much of 2020.
format	article
author	Pavithra Jayasundara Kalaiarasu M. Peariasamy Kian Boon Law Ku Nurhasni Ku Abd Rahim Sit Wai Lee Izzuna Mudla M. Ghazali Milinda Abayawardana Linh-Vi Le Rukun K.S. Khalaf Karina Razali Xuan Le Zhuo Lin Chong Emma S. McBryde Michael T. Meehan Jamie M. Caldwell Romain Ragonnet James M. Trauer
author_facet	Pavithra Jayasundara Kalaiarasu M. Peariasamy Kian Boon Law Ku Nurhasni Ku Abd Rahim Sit Wai Lee Izzuna Mudla M. Ghazali Milinda Abayawardana Linh-Vi Le Rukun K.S. Khalaf Karina Razali Xuan Le Zhuo Lin Chong Emma S. McBryde Michael T. Meehan Jamie M. Caldwell Romain Ragonnet James M. Trauer
author_sort	Pavithra Jayasundara
title	Sustaining effective COVID-19 control in Malaysia through large-scale vaccination
title_short	Sustaining effective COVID-19 control in Malaysia through large-scale vaccination
title_full	Sustaining effective COVID-19 control in Malaysia through large-scale vaccination
title_fullStr	Sustaining effective COVID-19 control in Malaysia through large-scale vaccination
title_full_unstemmed	Sustaining effective COVID-19 control in Malaysia through large-scale vaccination
title_sort	sustaining effective covid-19 control in malaysia through large-scale vaccination
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/e6d1e6283fdc488baa93bcfb0c0fe654
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Sustaining effective COVID-19 control in Malaysia through large-scale vaccination

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