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Health technology assessment
Original research
Epidemiological impact of prioritising SARS-CoV-2 vaccination by antibody status: mathematical modelling analyses
  1. Houssein H Ayoub1,
  2. Hiam Chemaitelly2,3,
  3. Monia Makhoul2,3,4,
  4. Zaina Al Kanaani5,
  5. Einas Al Kuwari5,
  6. Adeel A Butt4,5,
  7. Peter Coyle5,
  8. Andrew Jeremijenko5,
  9. Anvar Hassan Kaleeckal5,
  10. Ali Nizar Latif5,
  11. Riyazuddin Mohammad Shaik5,
  12. Hanan F Abdul Rahim6,
  13. Gheyath K Nasrallah7,8,
  14. Hadi M Yassine7,8,
  15. Mohamed G Al Kuwari9,
  16. Hamad Eid Al Romaihi10,
  17. Mohamed H Al-Thani10,
  18. Roberto Bertollini10,
  19. Abdullatif Al Khal5,
  20. Laith J Abu-Raddad2,3,4
  1. 1 Department of Mathematics, Statistics, and Physics, Qatar University, Doha, Qatar
  2. 2 Infectious Disease Epidemiology Group, Weill Cornell Medicine—Qatar, Cornell University, Doha, Qatar
  3. 3 World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine—Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
  4. 4 Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York City, New York, USA
  5. 5 Hamad Medical Corporation, Doha, Qatar
  6. 6 College of Health Sciences, QU Health, Qatar University, Doha, Qatar
  7. 7 Biomedical Research Center, Qatar University, Doha, Qatar
  8. 8 Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
  9. 9 Primary Health Care Corporation, Doha, Qatar
  10. 10 Ministry of Public Health, Doha, Qatar
  1. Correspondence to Dr Houssein H Ayoub, Department of Mathematics, Statistics, and Physics, Qatar University, P.O. Box 2713, Doha, Qatar; hayoub{at}qu.edu.qa; Dr Laith J Abu-Raddad, Infectious Disease Epidemiology Group, World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine—Qatar, Qatar Foundation - Education City, P.O. Box 24144, Doha, Qatar; lja2002{at}qatar-med.cornell.edu

Abstract

Background Vaccines against SARS-CoV-2 have been developed, but their availability falls far short of global needs. This study aimed to investigate the impact of prioritising available doses on the basis of recipient antibody status, that is by exposure status, using Qatar as an example.

Methods Vaccination impact (defined as the reduction in infection incidence and the number of vaccinations needed to avert one infection or one adverse disease outcome) was assessed under different scale-up scenarios using a deterministic meta-population mathematical model describing SARS-CoV-2 transmission and disease progression in the presence of vaccination.

Results For a vaccine that protects against infection with an efficacy of 95%, half as many vaccinations were needed to avert one infection, disease outcome or death by prioritising antibody-negative individuals for vaccination. Prioritisation by antibody status reduced incidence at a faster rate and led to faster elimination of infection and return to normalcy. Further prioritisation by age group amplified the gains of prioritisation by antibody status. Gains from prioritisation by antibody status were largest in settings where the proportion of the population already infected at the commencement of vaccination was 30%–60%. For a vaccine that only protects against disease and not infection, vaccine impact was reduced by half, whether this impact was measured in terms of averted infections or disease outcomes, but the relative gains from using antibody status to prioritise vaccination recipients were similar.

Conclusions Major health and economic gains can be achieved more quickly by prioritizing those who are antibody-negative while doses of the vaccine remain in short supply.

  • vaccination
  • COVID-19
  • public health
  • communicable diseases

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bmjinnov-2021-000677

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplemental information.

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    Footnotes

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    • Contributors HHA co-designed the study, constructed and parameterised the mathematical model, conducted the mathematical modelling analyses and co-wrote the first draft of the manuscript. HC conducted the statistical analyses and contributed to the parameterisation of the mathematical model. LJA-R conceived and co-designed the study, led the conduct of the analyses and co-wrote the first draft of the manuscript. All authors contributed to conceptualisation of the analyses, discussion and interpretation of the results and writing of the manuscript. All authors have read and approved the final manuscript.

    • Funding This study received support from the Biomedical Research Program, and the Biostatistics, Epidemiology, and Biomathematics Research Core, all at Weill Cornell Medicine-Qatar, as well as support provided by the Ministry of Public Health and Hamad Medical Corporation. The developed mathematical models were made possible by NPRP grant number 9-040-3-008 (principal investigator: LJA-R) and NPRP grant number 12S-0216-190094 (principal investigator: LJA-R) from the Qatar National Research Fund (a member of Qatar Foundation; https://www.qnrf.org).

    • Disclaimer The statements made herein are solely the responsibility of the authors. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.