Cargando…
Rural prioritization may increase the impact of COVID-19 vaccines in a representative COVAX AMC country setting due to ongoing internal migration: A modeling study
How COVID-19 vaccine is distributed within low- and middle-income countries has received little attention outside of equity or logistical concerns but may ultimately affect campaign impact in terms of infections, severe cases, or deaths averted. In this study we examined whether subnational (urban-r...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021691/ https://www.ncbi.nlm.nih.gov/pubmed/36962090 http://dx.doi.org/10.1371/journal.pgph.0000053 |
_version_ | 1784908555269177344 |
---|---|
author | Selvaraj, Prashanth Wagner, Bradley G. Chao, Dennis L. Jackson, Maïna L’Azou Breugelmans, J. Gabrielle Jackson, Nicholas Chang, Stewart T. |
author_facet | Selvaraj, Prashanth Wagner, Bradley G. Chao, Dennis L. Jackson, Maïna L’Azou Breugelmans, J. Gabrielle Jackson, Nicholas Chang, Stewart T. |
author_sort | Selvaraj, Prashanth |
collection | PubMed |
description | How COVID-19 vaccine is distributed within low- and middle-income countries has received little attention outside of equity or logistical concerns but may ultimately affect campaign impact in terms of infections, severe cases, or deaths averted. In this study we examined whether subnational (urban-rural) prioritization may affect the cumulative two-year impact on disease transmission and burden of a vaccination campaign using an agent-based model of COVID-19 in a representative COVID-19 Vaccines Global Access (COVAX) Advanced Market Commitment (AMC) setting. We simulated a range of vaccination strategies that differed by urban-rural prioritization, age group prioritization, timing of introduction, and final coverage level. Urban prioritization averted more infections in only a narrow set of scenarios, when internal migration rates were low and vaccination was started by day 30 of an outbreak. Rural prioritization was the optimal strategy for all other scenarios, e.g., with higher internal migration rates or later start dates, due to the presence of a large immunological naive rural population. Among other factors, timing of the vaccination campaign was important to determining maximum impact, and delays as short as 30 days prevented larger campaigns from having the same impact as smaller campaigns that began earlier. The optimal age group for prioritization depended on choice of metric, as prioritizing older adults consistently averted more deaths across all of the scenarios. While guidelines exist for these latter factors, urban-rural allocation is an orthogonal factor that we predict to affect impact and warrants consideration as countries plan the scale-up of their vaccination campaigns. |
format | Online Article Text |
id | pubmed-10021691 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-100216912023-03-17 Rural prioritization may increase the impact of COVID-19 vaccines in a representative COVAX AMC country setting due to ongoing internal migration: A modeling study Selvaraj, Prashanth Wagner, Bradley G. Chao, Dennis L. Jackson, Maïna L’Azou Breugelmans, J. Gabrielle Jackson, Nicholas Chang, Stewart T. PLOS Glob Public Health Research Article How COVID-19 vaccine is distributed within low- and middle-income countries has received little attention outside of equity or logistical concerns but may ultimately affect campaign impact in terms of infections, severe cases, or deaths averted. In this study we examined whether subnational (urban-rural) prioritization may affect the cumulative two-year impact on disease transmission and burden of a vaccination campaign using an agent-based model of COVID-19 in a representative COVID-19 Vaccines Global Access (COVAX) Advanced Market Commitment (AMC) setting. We simulated a range of vaccination strategies that differed by urban-rural prioritization, age group prioritization, timing of introduction, and final coverage level. Urban prioritization averted more infections in only a narrow set of scenarios, when internal migration rates were low and vaccination was started by day 30 of an outbreak. Rural prioritization was the optimal strategy for all other scenarios, e.g., with higher internal migration rates or later start dates, due to the presence of a large immunological naive rural population. Among other factors, timing of the vaccination campaign was important to determining maximum impact, and delays as short as 30 days prevented larger campaigns from having the same impact as smaller campaigns that began earlier. The optimal age group for prioritization depended on choice of metric, as prioritizing older adults consistently averted more deaths across all of the scenarios. While guidelines exist for these latter factors, urban-rural allocation is an orthogonal factor that we predict to affect impact and warrants consideration as countries plan the scale-up of their vaccination campaigns. Public Library of Science 2022-01-27 /pmc/articles/PMC10021691/ /pubmed/36962090 http://dx.doi.org/10.1371/journal.pgph.0000053 Text en © 2022 Selvaraj et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Selvaraj, Prashanth Wagner, Bradley G. Chao, Dennis L. Jackson, Maïna L’Azou Breugelmans, J. Gabrielle Jackson, Nicholas Chang, Stewart T. Rural prioritization may increase the impact of COVID-19 vaccines in a representative COVAX AMC country setting due to ongoing internal migration: A modeling study |
title | Rural prioritization may increase the impact of COVID-19 vaccines in a representative COVAX AMC country setting due to ongoing internal migration: A modeling study |
title_full | Rural prioritization may increase the impact of COVID-19 vaccines in a representative COVAX AMC country setting due to ongoing internal migration: A modeling study |
title_fullStr | Rural prioritization may increase the impact of COVID-19 vaccines in a representative COVAX AMC country setting due to ongoing internal migration: A modeling study |
title_full_unstemmed | Rural prioritization may increase the impact of COVID-19 vaccines in a representative COVAX AMC country setting due to ongoing internal migration: A modeling study |
title_short | Rural prioritization may increase the impact of COVID-19 vaccines in a representative COVAX AMC country setting due to ongoing internal migration: A modeling study |
title_sort | rural prioritization may increase the impact of covid-19 vaccines in a representative covax amc country setting due to ongoing internal migration: a modeling study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021691/ https://www.ncbi.nlm.nih.gov/pubmed/36962090 http://dx.doi.org/10.1371/journal.pgph.0000053 |
work_keys_str_mv | AT selvarajprashanth ruralprioritizationmayincreasetheimpactofcovid19vaccinesinarepresentativecovaxamccountrysettingduetoongoinginternalmigrationamodelingstudy AT wagnerbradleyg ruralprioritizationmayincreasetheimpactofcovid19vaccinesinarepresentativecovaxamccountrysettingduetoongoinginternalmigrationamodelingstudy AT chaodennisl ruralprioritizationmayincreasetheimpactofcovid19vaccinesinarepresentativecovaxamccountrysettingduetoongoinginternalmigrationamodelingstudy AT jacksonmainalazou ruralprioritizationmayincreasetheimpactofcovid19vaccinesinarepresentativecovaxamccountrysettingduetoongoinginternalmigrationamodelingstudy AT breugelmansjgabrielle ruralprioritizationmayincreasetheimpactofcovid19vaccinesinarepresentativecovaxamccountrysettingduetoongoinginternalmigrationamodelingstudy AT jacksonnicholas ruralprioritizationmayincreasetheimpactofcovid19vaccinesinarepresentativecovaxamccountrysettingduetoongoinginternalmigrationamodelingstudy AT changstewartt ruralprioritizationmayincreasetheimpactofcovid19vaccinesinarepresentativecovaxamccountrysettingduetoongoinginternalmigrationamodelingstudy |