4.8 Article

Model-informed COVID-19 vaccine prioritization strategies by age and serostatus


Volume 371, Issue 6532, Pages 916-+


DOI: 10.1126/science.abe6959




  1. Interdisciplinary Quantitative Biology (IQ Biology) Ph.D. program at the BioFrontiers Institute, University of Colorado Boulder
  2. MIDAS Coordination Center [MIDASNI2020-2]
  3. National Institute of General Medical Science [3U24GM132013-02S2]
  4. Morris-Singer Fund for the Center for Communicable Disease Dynamics at the Harvard T. H. Chan School of Public Health
  5. SeroNet program of the National Cancer Institute [1U01CA261277-01]

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The study found that prioritizing the vaccine for adults aged 20 to 49 can minimize the number of cases, while prioritizing the vaccine for adults over 60 can minimize mortality and years of life lost. Redirecting vaccine doses to seronegative individuals through individual-level serological tests can improve the impact of each dose.
Limited initial supply of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine raises the question of how to prioritize available doses. We used a mathematical model to compare five age-stratified prioritization strategies. A highly effective transmission-blocking vaccine prioritized to adults ages 20 to 49 years minimized cumulative incidence, but mortality and years of life lost were minimized in most scenarios when the vaccine was prioritized to adults greater than 60 years old. Use of individual-level serological tests to redirect doses to seronegative individuals improved the marginal impact of each dose while potentially reducing existing inequities in COVID-19 impact. Although maximum impact prioritization strategies were broadly consistent across countries, transmission rates, vaccination rollout speeds, and estimates of naturally acquired immunity, this framework can be used to compare impacts of prioritization strategies across contexts.


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