不完善的疫苗能否遏制美国的COVID-19大流行?

IF 3 Q2 INFECTIOUS DISEASES 传染病建模(英文) Pub Date : 2020-05-14 DOI:10.1101/2020.05.10.20097428
E. Iboi, C. Ngonghala, A. Gumel
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引用次数: 160

摘要

摘要2019年12月下旬从中国武汉市出现的新型冠状病毒(新冠肺炎)继续在世界各地造成毁灭性的公共卫生和经济挑战。尽管社区范围内实施的基本非药物干预措施,如保持社交距离、隔离新冠肺炎疑似病例、隔离确诊病例、在公共场合使用口罩、追踪接触者和检测,在减少和减轻疫情负担方面相当有效,人们普遍认为,使用疫苗可能是有效遏制和消除人群中新冠肺炎的必要条件。这项研究基于使用数学模型来评估假设的不完善的抗新冠肺炎疫苗对美国新冠肺炎控制的影响。导出了为实现疫苗诱导的社区群体免疫而需要接种疫苗的未接种易感个体的最小百分比的分析表达式。群体免疫阈值的流行病学后果是,如果在社区中达到最低群体免疫阈值,疾病可以得到有效控制或消除。使用通过将模型与美国新冠肺炎死亡率数据拟合获得的基线参数值对该模型进行的模拟表明,对于假设保护效力为80%的抗新冠肺炎疫苗,至少82%的易感美国人群需要接种疫苗才能达到群体免疫阈值。如果疫苗接种计划与其他干预措施相结合,如使用口罩和/或保持社交距离,那么使用假设疫苗在美国消除新冠肺炎的前景将大大增强。这种策略的结合大大降低了消除美国疫情所需的疫苗诱导的群体免疫阈值水平。例如,如果一半的美国人口经常在公共场合戴口罩,群体免疫阈值将降至72%(如果每个人都戴口罩,阈值将降至46%)。
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Will an imperfect vaccine curtail the COVID-19 pandemic in the U.S.?
Abstract The novel coronavirus (COVID-19) that emerged from Wuhan city of China in late December 2019 continue to pose devastating public health and economic challenges across the world. Although the community-wide implementation of basic non-pharmaceutical intervention measures, such as social distancing, quarantine of suspected COVID-19 cases, isolation of confirmed cases, use of face masks in public, contact tracing and testing, have been quite effective in curtailing and mitigating the burden of the pandemic, it is universally believed that the use of a vaccine may be necessary to effectively curtail and eliminating COVID-19 in human populations. This study is based on the use of a mathematical model for assessing the impact of a hypothetical imperfect anti-COVID-19 vaccine on the control of COVID-19 in the United States. An analytical expression for the minimum percentage of unvaccinated susceptible individuals needed to be vaccinated in order to achieve vaccine-induced community herd immunity is derived. The epidemiological consequence of the herd immunity threshold is that the disease can be effectively controlled or eliminated if the minimum herd immunity threshold is achieved in the community. Simulations of the model, using baseline parameter values obtained from fitting the model with COVID-19 mortality data for the U.S., show that, for an anti-COVID-19 vaccine with an assumed protective efficacy of 80%, at least 82% of the susceptible US population need to be vaccinated to achieve the herd immunity threshold. The prospect of COVID-19 elimination in the US, using the hypothetical vaccine, is greatly enhanced if the vaccination program is combined with other interventions, such as face mask usage and/or social distancing. Such combination of strategies significantly reduces the level of the vaccine-induced herd immunity threshold needed to eliminate the pandemic in the US. For instance, the herd immunity threshold decreases to 72% if half of the US population regularly wears face masks in public (the threshold decreases to 46% if everyone wears a face mask).
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