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. 2021 Apr;174(4):570-572.
doi: 10.7326/M20-8137. Epub 2021 Jan 5.

Alternative Dose Allocation Strategies to Increase Benefits From Constrained COVID-19 Vaccine Supply

Ashleigh R Tuite  1 , Lin Zhu  2 , David N Fisman  1 , Joshua A Salomon  2
Affiliations

Alternative Dose Allocation Strategies to Increase Benefits From Constrained COVID-19 Vaccine Supply

Ashleigh R Tuite et al. Ann Intern Med. 2021 Apr.
No abstract available

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Conflict of interest statement

Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-8137.

Figures

Figure 1.
Figure 1.. Model-projected outcomes of alternative vaccine allocation strategies. A.
Illustrative example of doses administered over time for the fixed and flexible strategies in a stable vaccine supply scenario (6 million doses per week). Total effective population protection represents the equivalent number of people benefiting from vaccine-associated protection against COVID-19, calculated as the number of people vaccinated with 1 or 2 doses multiplied by vaccine efficacy with 1 or 2 doses, allowing for waning protection with delayed second dose. B. Reductions in COVID-19 incidence through the fixed and flexible strategies, under the stable supply scenario and an alternative scenario with reduced supply (down from 6 million doses per week in the first 3 weeks, to 3 million doses per week afterward). Averted incidence expressed as percentage reductions in each week compared with no vaccination, which are not dependent on assumed incidence trends.
Figure 2.
Figure 2.. Model-projected outcomes of alternative vaccine allocation strategies under varying assumptions of vaccine supply, vaccine characteristics, and incidence trends. A.
Numbers of people vaccinated and completion of vaccination series for the flexible and fixed strategies, under different supply and efficacy scenarios. For the moderate and large supply reduction scenarios, supply was reduced to one half or one tenth of the initial supply, respectively, from week 4 onward. Total effective population protection represents the equivalent number of people benefiting from vaccine-associated protection against COVID-19, calculated as the number vaccinated with 1 or 2 doses by week 8 multiplied by vaccine efficacy with 1 or 2 doses. Results are independent of assumed incidence trends. B. Percentage of infections averted using the flexible strategy relative to the fixed strategy for the different scenarios and under different incidence trends. Stable incidence assumes constant weekly incidence of infection for weeks 1 to 8; increasing incidence assumes a monotonic increase that produces a doubling of incidence over 8 weeks. Peaking assumes sharp rise to a peak after week 4, followed by a decline to the week-1 level by week 8.
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References

    1. Polack FP , Thomas SJ , Kitchin N , et al; C4591001 Clinical Trial Group. Safety and efficacy of the BNT162b2 mRNA covid-19 vaccine. N Engl J Med. 2020;383:2603-15. [PMID: ] doi: 10.1056/NEJMoa2034577 - DOI - PMC - PubMed
    1. Baden LR , El Sahly HM , Essink B , et al; COVE Study Group. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2020. [PMID: ] doi: 10.1056/NEJMoa2035389 - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention. COVID-19 vaccine distribution allocations by jurisdiction—Pfizer. Accessed at https://data.cdc.gov/Vaccinations/COVID-19-Vaccine-Distribution-Allocati... on 27 December 2020.

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