TY - JOUR
T1 - Modeling geographic vaccination strategies for COVID-19 in Norway
AU - Chan, Louis Yat Hin
AU - Rø, Gunnar
AU - Midtbø, Jørgen Eriksson
AU - Ruscio, Francesco Di
AU - Watle, Sara Sofie Viksmoen
AU - Juvet, Lene Kristine
AU - Littmann, Jasper
AU - Aavitsland, Preben
AU - Nygård, Karin Maria
AU - Berg, Are Stuwitz
AU - Bukholm, Geir
AU - Kristoffersen, Anja Bråthen
AU - Engø-Monsen, Kenth
AU - Engebretsen, Solveig
AU - Swanson, David
AU - Palomares, Alfonso Diz Lois
AU - Lindstrøm, Jonas Christoffer
AU - Frigessi, Arnoldo
AU - Blasio, Birgitte Freiesleben de
N1 - Publisher Copyright:
© 2024 Chan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License,
PY - 2024/1
Y1 - 2024/1
N2 - Vaccination was a key intervention in controlling the COVID-19 pandemic globally. In early 2021, Norway faced significant regional variations in COVID-19 incidence and prevalence, with large differences in population density, necessitating efficient vaccine allocation to reduce infections and severe outcomes. This study explored alternative vaccination strategies to minimize health outcomes (infections, hospitalizations, ICU admissions, deaths) by varying regions prioritized, extra doses prioritized, and implementation start time. Using two models (individual-based and meta-population), we simulated COVID-19 transmission during the primary vaccination period in Norway, covering the first 7 months of 2021. We investigated alternative strategies to allocate more vaccine doses to regions with a higher force of infection. We also examined the robustness of our results and highlighted potential structural differences between the two models. Our findings suggest that early vaccine prioritization could reduce COVID-19 related health outcomes by 8% to 20% compared to a baseline strategy without geographic prioritization. For minimizing infections, hospitalizations, or ICU admissions, the best strategy was to initially allocate all available vaccine doses to fewer high-risk municipalities, comprising approximately one-fourth of the population. For minimizing deaths, a moderate level of geographic prioritization, with approximately one-third of the population receiving doubled doses, gave the best outcomes by balancing the trade-off between vaccinating younger people in high-risk areas and older people in low-risk areas. The actual strategy implemented in Norway was a two-step moderate level aimed at maintaining the balance and ensuring ethical considerations and public trust. However, it did not offer significant advantages over the baseline strategy without geographic prioritization. Earlier implementation of geographic prioritization could have more effectively addressed the main wave of infections, substantially reducing the national burden of the pandemic.
AB - Vaccination was a key intervention in controlling the COVID-19 pandemic globally. In early 2021, Norway faced significant regional variations in COVID-19 incidence and prevalence, with large differences in population density, necessitating efficient vaccine allocation to reduce infections and severe outcomes. This study explored alternative vaccination strategies to minimize health outcomes (infections, hospitalizations, ICU admissions, deaths) by varying regions prioritized, extra doses prioritized, and implementation start time. Using two models (individual-based and meta-population), we simulated COVID-19 transmission during the primary vaccination period in Norway, covering the first 7 months of 2021. We investigated alternative strategies to allocate more vaccine doses to regions with a higher force of infection. We also examined the robustness of our results and highlighted potential structural differences between the two models. Our findings suggest that early vaccine prioritization could reduce COVID-19 related health outcomes by 8% to 20% compared to a baseline strategy without geographic prioritization. For minimizing infections, hospitalizations, or ICU admissions, the best strategy was to initially allocate all available vaccine doses to fewer high-risk municipalities, comprising approximately one-fourth of the population. For minimizing deaths, a moderate level of geographic prioritization, with approximately one-third of the population receiving doubled doses, gave the best outcomes by balancing the trade-off between vaccinating younger people in high-risk areas and older people in low-risk areas. The actual strategy implemented in Norway was a two-step moderate level aimed at maintaining the balance and ensuring ethical considerations and public trust. However, it did not offer significant advantages over the baseline strategy without geographic prioritization. Earlier implementation of geographic prioritization could have more effectively addressed the main wave of infections, substantially reducing the national burden of the pandemic.
UR - http://www.scopus.com/inward/record.url?scp=85183999896&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85183999896&partnerID=8YFLogxK
U2 - 10.1371/journal.pcbi.1011426
DO - 10.1371/journal.pcbi.1011426
M3 - Article
C2 - 38295111
AN - SCOPUS:85183999896
SN - 1553-734X
VL - 20
JO - PLoS computational biology
JF - PLoS computational biology
IS - 1
ER -