Evaluation of COVID-19 vaccination strategies with a delayed second dose

Moghadas, Seyed M.; Vilches, Thomas N.; Zhang, Kevin; Nourbakhsh, Shokoofeh; Sah, Pratha; Fitzpatrick, Meagan C.; Galvani, Alison P.

Evaluation of COVID-19 vaccination strategies with a delayed second dose

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creativework.keywords - en: COVID-19 / epidemiology; COVID-19 / immunology actions Search in PubMed Search in MeSH Add to Search; COVID-19 / prevention & control*; COVID-19 Vaccines / administration & dosage*; COVID-19 Vaccines / supply & distribution; Hospitalization / statistics & numerical data; Humans; Immunization Schedule; Immunization, Secondary; Models, Statistical; Mortality; SARS-CoV-2 / immunology*; United States / epidemiology; Vaccination / methods*; Vaccination / statistics & numerical data
dc.contributor.author: Moghadas, Seyed M.; Vilches, Thomas N.; Zhang, Kevin; Nourbakhsh, Shokoofeh; Sah, Pratha; Fitzpatrick, Meagan C.; Galvani, Alison P.
dc.date.accessioned: 2024-03-22T19:00:31Z
dc.date.available: 2024-03-22T19:00:31Z
dc.date.issued: 2021-04-21
dc.description - en: Two of the Coronavirus Disease 2019 (COVID-19) vaccines currently approved in the United States require 2 doses, administered 3 to 4 weeks apart. Constraints in vaccine supply and distribution capacity, together with a deadly wave of COVID-19 from November 2020 to January 2021 and the emergence of highly contagious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants, sparked a policy debate on whether to vaccinate more individuals with the first dose of available vaccines and delay the second dose or to continue with the recommended 2-dose series as tested in clinical trials. We developed an agent-based model of COVID-19 transmission to compare the impact of these 2 vaccination strategies. Our results show that for Moderna vaccines, a delay of at least 9 weeks could avert at least an additional 17.3 infections, 0.69 hospitalizations, and 0.34 deaths per 10,000 population compared to the recommended 4-week interval. Pfizer-BioNTech vaccines also averted an additional 0.60 hospitalizations and 0.32 deaths per 10,000 population in a 9-week delayed second dose. However, there was no clear advantage of delaying the second dose with Pfizer-BioNTech vaccines in reducing infections, unless the efficacy of the first dose did not wane over time.
dc.description.abstract - en: Two of the Coronavirus Disease 2019 (COVID-19) vaccines currently approved in the United States require 2 doses, administered 3 to 4 weeks apart. Constraints in vaccine supply and distribution capacity, together with a deadly wave of COVID-19 from November 2020 to January 2021 and the emergence of highly contagious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants, sparked a policy debate on whether to vaccinate more individuals with the first dose of available vaccines and delay the second dose or to continue with the recommended 2-dose series as tested in clinical trials. We developed an agent-based model of COVID-19 transmission to compare the impact of these 2 vaccination strategies, while varying the temporal waning of vaccine efficacy following the first dose and the level of preexisting immunity in the population. Our results show that for Moderna vaccines, a delay of at least 9 weeks could maximize vaccination program effectiveness and avert at least an additional 17.3 (95% credible interval [CrI]: 7.8–29.7) infections, 0.69 (95% CrI: 0.52–0.97) hospitalizations, and 0.34 (95% CrI: 0.25–0.44) deaths per 10,000 population compared to the recommended 4-week interval between the 2 doses. Pfizer-BioNTech vaccines also averted an additional 0.60 (95% CrI: 0.37–0.89) hospitalizations and 0.32 (95% CrI: 0.23–0.45) deaths per 10,000 population in a 9-week delayed second dose (DSD) strategy compared to the 3-week recommended schedule between doses. However, there was no clear advantage of delaying the second dose with Pfizer-BioNTech vaccines in reducing infections, unless the efficacy of the first dose did not wane over time. Our findings underscore the importance of quantifying the characteristics and durability of vaccine-induced protection after the first dose in order to determine the optimal time interval between the 2 doses.
dc.identifier.citation: Moghadas SM, Vilches TN, Zhang K, Nourbakhsh S, Sah P, Fitzpatrick MC, et al. (2021) Evaluation of COVID-19 vaccination strategies with a delayed second dose. PLoS Biol 19(4): e3001211. https://doi.org/10.1371/journal.pbio.3001211
dc.identifier.doi: https://doi.org/10.1371/journal.pbio.3001211
dc.identifier.pubmedID: 33882066
dc.identifier.uri: https://open-science.canada.ca/handle/123456789/2189
dc.language.iso: en
dc.publisher: PLOS Biology
dc.rights - en: Creative Commons Attribution 4.0 International (CC BY 4.0)
dc.rights - fr: Creative Commons Attribution 4.0 International (CC BY 4.0)
dc.rights.openaccesslevel - en: Gold
dc.rights.openaccesslevel - fr: Or
dc.rights.uri - en: https://creativecommons.org/licenses/by/4.0/
dc.rights.uri - fr: https://creativecommons.org/licenses/by/4.0/deed.fr
dc.subject - en: Health
dc.subject - fr: Santé
dc.subject.en - en: Health
dc.subject.fr - fr: Santé
dc.title - en: Evaluation of COVID-19 vaccination strategies with a delayed second dose
dc.type - en: Article
dc.type - fr: Article
local.acceptedmanuscript.articlenum: e3001211
local.article.journalissue: 7
local.article.journaltitle: PLOS Biology
local.article.journalvolume: 19
local.peerreview - en: Yes
local.peerreview - fr: Oui

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