Prioritizing COVID-19 vaccination efforts and dose allocation within Madagascar
Abstract Background While mass COVID-19 vaccination programs are underway in high-income countries, limited availability of doses has resulted in few vaccines administered in low and middle income countries (LMICs). The COVID-19 Vaccines Global Access (COVAX) is a WHO-led initiative to promote vacci...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Public Health |
| Online Access: | https://doi.org/10.1186/s12889-022-13150-8 |
| _version_ | 1817990729418407936 |
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| author | Fidisoa Rasambainarivo Tanjona Ramiadantsoa Antso Raherinandrasana Santatra Randrianarisoa Benjamin L. Rice Michelle V. Evans Benjamin Roche Fidiniaina Mamy Randriatsarafara Amy Wesolowski Jessica C. Metcalf |
| author_facet | Fidisoa Rasambainarivo Tanjona Ramiadantsoa Antso Raherinandrasana Santatra Randrianarisoa Benjamin L. Rice Michelle V. Evans Benjamin Roche Fidiniaina Mamy Randriatsarafara Amy Wesolowski Jessica C. Metcalf |
| author_sort | Fidisoa Rasambainarivo |
| collection | DOAJ |
| description | Abstract Background While mass COVID-19 vaccination programs are underway in high-income countries, limited availability of doses has resulted in few vaccines administered in low and middle income countries (LMICs). The COVID-19 Vaccines Global Access (COVAX) is a WHO-led initiative to promote vaccine access equity to LMICs and is providing many of the doses available in these settings. However, initial doses are limited and countries, such as Madagascar, need to develop prioritization schemes to maximize the benefits of vaccination with very limited supplies. There is some consensus that dose deployment should initially target health care workers, and those who are more vulnerable including older individuals. However, questions of geographic deployment remain, in particular associated with limits around vaccine access and delivery capacity in underserved communities, for example in rural areas that may also include substantial proportions of the population. Methods To address these questions, we developed a mathematical model of SARS-CoV-2 transmission dynamics and simulated various vaccination allocation strategies for Madagascar. Simulated strategies were based on a number of possible geographical prioritization schemes, testing sensitivity to initial susceptibility in the population, and evaluating the potential of tests for previous infection. Results Using cumulative deaths due to COVID-19 as the main outcome of interest, our results indicate that distributing the number of vaccine doses according to the number of elderly living in the region or according to the population size results in a greater reduction of mortality compared to distributing doses based on the reported number of cases and deaths. The benefits of vaccination strategies are diminished if the burden (and thus accumulated immunity) has been greatest in the most populous regions, but the overall strategy ranking remains comparable. If rapid tests for prior immunity may be swiftly and effectively delivered, there is potential for considerable gain in mortality averted, but considering delivery limitations modulates this. Conclusion At a subnational scale, our results support the strategy adopted by the COVAX initiative at a global scale. |
| first_indexed | 2024-04-14T01:03:51Z |
| format | Article |
| id | doaj.art-f792d73ae3e74d2a911dcd8898b73a7a |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-14T01:03:51Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-f792d73ae3e74d2a911dcd8898b73a7a2022-12-22T02:21:20ZengBMCBMC Public Health1471-24582022-04-012211910.1186/s12889-022-13150-8Prioritizing COVID-19 vaccination efforts and dose allocation within MadagascarFidisoa Rasambainarivo0Tanjona Ramiadantsoa1Antso Raherinandrasana2Santatra Randrianarisoa3Benjamin L. Rice4Michelle V. Evans5Benjamin Roche6Fidiniaina Mamy Randriatsarafara7Amy Wesolowski8Jessica C. Metcalf9Department of Ecology and Evolutionary Biology, Princeton UniversityDepartment of Life Science, University of FianarantsoaSurveillance Unit, Ministry of Health of MadagascarMahaliana Labs SARLDepartment of Ecology and Evolutionary Biology, Princeton UniversityMIVEGEC, Université de Montpellier, CNRSMIVEGEC, Université de Montpellier, CNRSFaculty of Medicine, University of AntananarivoDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthDepartment of Ecology and Evolutionary Biology, Princeton UniversityAbstract Background While mass COVID-19 vaccination programs are underway in high-income countries, limited availability of doses has resulted in few vaccines administered in low and middle income countries (LMICs). The COVID-19 Vaccines Global Access (COVAX) is a WHO-led initiative to promote vaccine access equity to LMICs and is providing many of the doses available in these settings. However, initial doses are limited and countries, such as Madagascar, need to develop prioritization schemes to maximize the benefits of vaccination with very limited supplies. There is some consensus that dose deployment should initially target health care workers, and those who are more vulnerable including older individuals. However, questions of geographic deployment remain, in particular associated with limits around vaccine access and delivery capacity in underserved communities, for example in rural areas that may also include substantial proportions of the population. Methods To address these questions, we developed a mathematical model of SARS-CoV-2 transmission dynamics and simulated various vaccination allocation strategies for Madagascar. Simulated strategies were based on a number of possible geographical prioritization schemes, testing sensitivity to initial susceptibility in the population, and evaluating the potential of tests for previous infection. Results Using cumulative deaths due to COVID-19 as the main outcome of interest, our results indicate that distributing the number of vaccine doses according to the number of elderly living in the region or according to the population size results in a greater reduction of mortality compared to distributing doses based on the reported number of cases and deaths. The benefits of vaccination strategies are diminished if the burden (and thus accumulated immunity) has been greatest in the most populous regions, but the overall strategy ranking remains comparable. If rapid tests for prior immunity may be swiftly and effectively delivered, there is potential for considerable gain in mortality averted, but considering delivery limitations modulates this. Conclusion At a subnational scale, our results support the strategy adopted by the COVAX initiative at a global scale.https://doi.org/10.1186/s12889-022-13150-8 |
| spellingShingle | Fidisoa Rasambainarivo Tanjona Ramiadantsoa Antso Raherinandrasana Santatra Randrianarisoa Benjamin L. Rice Michelle V. Evans Benjamin Roche Fidiniaina Mamy Randriatsarafara Amy Wesolowski Jessica C. Metcalf Prioritizing COVID-19 vaccination efforts and dose allocation within Madagascar BMC Public Health |
| title | Prioritizing COVID-19 vaccination efforts and dose allocation within Madagascar |
| title_full | Prioritizing COVID-19 vaccination efforts and dose allocation within Madagascar |
| title_fullStr | Prioritizing COVID-19 vaccination efforts and dose allocation within Madagascar |
| title_full_unstemmed | Prioritizing COVID-19 vaccination efforts and dose allocation within Madagascar |
| title_short | Prioritizing COVID-19 vaccination efforts and dose allocation within Madagascar |
| title_sort | prioritizing covid 19 vaccination efforts and dose allocation within madagascar |
| url | https://doi.org/10.1186/s12889-022-13150-8 |
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