Assessing the epidemiological and economic impact of alternative vaccination strategies: a modeling study

PURPOSE: Given limited supplies of vaccines, having information on the costs, and associated health and economic impacts, is important for the development of optimal vaccination strategies. This study explores the epidemiological and economic impact, in terms of the value of lost production, of four vaccination strategies – fixed-dose interval (M1), prioritization of the first dose (M2), screen and forego vaccine for those with COVID-19 infection history (M3), and prioritization of the first dose along with screen and forego vaccine for those with COVID-19 infection history(M4), under constraints limiting the daily vaccine supply. METHODS & MATERIALS: Using mathematical and statistical modelling, we quantified the number quarantined, hospitalization days, vaccine doses saved, and deaths averted, and production losses, for each strategy, in comparison to M1. The model parameters and initial conditions were based on Canadian data, and the simulation ran over 365 days starting from June 1, 2021. Sensitivity analyses explored how each strategy changes with different conditions of daily vaccine supply, the initial proportion recovered from COVID-19 infection, and initial coverage of the first dose. RESULTS: Strategy M2 results in a reduction of 67,130,775 doses of vaccine administered, 20 lives saved, and a reduction of $3.8 billion of lost production in comparison to M1. M3 does not save any vaccine dose administered, but results in 5 lives saved, and a reduction of $575,149 in lost production in comparison to strategy M1. Due to the large proportion of the Canadian population who have already received a first vaccine dose, no screening actually occurs under scenario M3 and the daily vaccine supply was used entirely to provide second doses. While M2 is the dominant strategy under the current Canadian setting, sensitivity analyses revealed that M3 dominates when the vaccine supply increased or when the initial recovered proportion from COVID-19 was large enough. CONCLUSION: The findings quantify the potential benefits of alternative vaccination strategies that can save lives and costs. Our study findings can help policymakers identify the optimal COVID-19 vaccination strategy and our study framework can be adapted to other settings.