Dataset Information

Optimal Allocation of the Limited COVID-19 Vaccine Supply in South Korea.

ABSTRACT: Initial supply of the coronavirus disease (COVID-19) vaccine may be limited, necessitating its effective use. Herein, an age-structured model of COVID-19 spread in South Korea is parameterized to understand the epidemiological characteristics of COVID-19. The model determines optimal vaccine allocation for minimizing infections, deaths, and years of life lost while accounting for population factors, such as country-specific age distribution and contact structure, and various levels of vaccine efficacy. A transmission-blocking vaccine should be prioritized in adults aged 20-49 years and those older than 50 years to minimize the cumulative incidence and mortality, respectively. A strategy to minimize years of life lost involves the vaccination of adults aged 40-69 years, reflecting the relatively high case-fatality rates and years of life lost in this age group. An incidence-minimizing vaccination strategy is highly sensitive to vaccine efficacy, and vaccines with lower efficacy should be administered to teenagers and adults aged 50-59 years. Consideration of age-specific contact rates and vaccine efficacy is critical to optimize vaccine allocation. New recommendations for COVID-19 vaccines under consideration by the Korean Centers for Disease Control and Prevention are mainly based on a mortality-minimizing allocation strategy.

SUBMITTER: Shim E

PROVIDER: S-EPMC7914460 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Optimal Allocation of the Limited COVID-19 Vaccine Supply in South Korea.

Shim Eunha E

Journal of clinical medicine 20210204 4

Initial supply of the coronavirus disease (COVID-19) vaccine may be limited, necessitating its effective use. Herein, an age-structured model of COVID-19 spread in South Korea is parameterized to understand the epidemiological characteristics of COVID-19. The model determines optimal vaccine allocation for minimizing infections, deaths, and years of life lost while accounting for population factors, such as country-specific age distribution and contact structure, and various levels of vaccine ef ...[more]

PMID: 33557344

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Project description:This study presents a new risk-averse multi-stage stochastic epidemics-ventilator-logistics compartmental model to address the resource allocation challenges of mitigating COVID-19. This epidemiological logistics model involves the uncertainty of untested asymptomatic infections and incorporates short-term human migration. Disease transmission is also forecasted through a new formulation of transmission rates that evolve over space and time with respect to various non-pharmaceutical interventions, such as wearing masks, social distancing, and lockdown. The proposed multi-stage stochastic model overviews different scenarios on the number of asymptomatic individuals while optimizing the distribution of resources, such as ventilators, to minimize the total expected number of newly infected and deceased people. The Conditional Value at Risk (CVaR) is also incorporated into the multi-stage mean-risk model to allow for a trade-off between the weighted expected loss due to the outbreak and the expected risks associated with experiencing disastrous pandemic scenarios. We apply our multi-stage mean-risk epidemics-ventilator-logistics model to the case of controlling COVID-19 in highly-impacted counties of New York and New Jersey. We calibrate, validate, and test our model using actual infection, population, and migration data. We also define a new region-based sub-problem and bounds on the problem and then show their computational benefits in terms of the optimality and relaxation gaps. The computational results indicate that short-term migration influences the transmission of the disease significantly. The optimal number of ventilators allocated to each region depends on various factors, including the number of initial infections, disease transmission rates, initial ICU capacity, the population of a geographical location, and the availability of ventilator supply. Our data-driven modeling framework can be adapted to study the disease transmission dynamics and logistics of other similar epidemics and pandemics.

Project description:For the control of COVID-19, vaccination programmes provide a long-term solution. The amount of available vaccines is often limited, and thus it is crucial to determine the allocation strategy. While mathematical modelling approaches have been used to find an optimal distribution of vaccines, there is an excessively large number of possible allocation schemes to be simulated. Here, we propose an algorithm to find a near-optimal allocation scheme given an intervention objective such as minimization of new infections, hospitalizations, or deaths, where multiple vaccines are available. The proposed principle for allocating vaccines is to target subgroups with the largest reduction in the outcome of interest. We use an approximation method to reconstruct the age-specific transmission intensity (the next generation matrix), and express the expected impact of vaccinating each subgroup in terms of the observed incidence of infection and force of infection. The proposed approach is firstly evaluated with a simulated epidemic and then applied to the epidemiological data on COVID-19 in the Netherlands. Our results reveal how the optimal allocation depends on the objective of infection control. In the case of COVID-19, if we wish to minimize deaths, the optimal allocation strategy is not efficient for minimizing other outcomes, such as infections. In simulated epidemics, an allocation strategy optimized for an outcome outperforms other strategies such as the allocation from young to old, from old to young, and at random. Our simulations clarify that the current policy in the Netherlands (i.e., allocation from old to young) was concordant with the allocation scheme that minimizes deaths. The proposed method provides an optimal allocation scheme, given routine surveillance data that reflect ongoing transmissions. This approach to allocation is useful for providing plausible simulation scenarios for complex models, which give a more robust basis to determine intervention strategies.

Project description:BackgroundThis study presents a framework for determining the allocation and distribution of the limited amount of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).MethodsAfter analyzing the pandemic strategies of the major organizations and countries and with a literature review conducted by a core panel, a modified Delphi survey was administered to 13 experts in the fields of vaccination, infectious disease, and public health in the Republic of Korea. The following topics were discussed: 1) identifying the objectives of the vaccination strategy, 2) identifying allocation criteria, and 3) establishing a step-by-step vaccination framework and prioritization strategy based on the allocation criteria. Two rounds of surveys were conducted for each topic, with a structured questionnaire provided via e-mail in the first round. After analyzing the responses, a meeting with the experts was held to obtain consensus on how to prioritize the population groups.ResultsThe first objective of the vaccination strategy was maintenance of the integrity of the healthcare system and critical infrastructure, followed by reduction of morbidity and mortality and reduction of community transmission. In the initial phase, older adult residents in care homes, high-risk health and social care workers, and personal support workers who work in direct contact with coronavirus disease 2019 (COVID-19) patients would be prioritized. Expansion of vaccine supply would allow immunization of older adults not included in phase 1, followed by healthcare workers not previously included and individuals with comorbidities. Further widespread vaccine supply would ensure availability to the extended adult age groups (50-64 years old), critical workers outside the health sector, residents who cannot socially distance, and, eventually, the remaining populations.ConclusionThis survey provides the much needed insight into the decision-making process for vaccine allocation at the national level. However, flexibility in adapting to strategies will be essential, as new information is constantly emerging.

Dataset Information

Optimal Allocation of the Limited COVID-19 Vaccine Supply in South Korea.

Publications

Optimal Allocation of the Limited COVID-19 Vaccine Supply in South Korea.

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