Vaccine roll-out

疫苗推广
  • 文章类型: Journal Article
    随着世界变得越来越紧密,大流行的机会也增加了。最近的COVID-19大流行和同时进行的全球大规模疫苗推广为学习和完善我们对传染病模型的理解提供了理想的环境,以更好地做好未来的准备。在这次审查中,我们系统地分析和分类已开发的数学模型,以设计最初有限疫苗的最佳疫苗优先策略。由于老年人不成比例地受到COVID-19的影响,重点是明确考虑年龄的模型。老年人的流动性和活动水平较低,这引起了不小的权衡。次要研究问题涉及疫苗剂量和空间疫苗分布之间的最佳时间间隔。这篇综述展示了各种建模假设对模型结果的影响。对这些关系的深入了解会产生更好的传染病模型,从而在下一次大流行期间做出公共卫生决策。
    As the world becomes ever more connected, the chance of pandemics increases as well. The recent COVID-19 pandemic and the concurrent global mass vaccine roll-out provides an ideal setting to learn from and refine our understanding of infectious disease models for better future preparedness. In this review, we systematically analyze and categorize mathematical models that have been developed to design optimal vaccine prioritization strategies of an initially limited vaccine. As older individuals are disproportionately affected by COVID-19, the focus is on models that take age explicitly into account. The lower mobility and activity level of older individuals gives rise to non-trivial trade-offs. Secondary research questions concern the optimal time interval between vaccine doses and spatial vaccine distribution. This review showcases the effect of various modeling assumptions on model outcomes. A solid understanding of these relationships yields better infectious disease models and thus public health decisions during the next pandemic.
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  • 文章类型: Preprint
    随着世界变得越来越紧密,大流行的机会也增加了。最近的COVID-19大流行和同时进行的全球大规模疫苗推广为学习和完善我们对传染病模型的理解提供了理想的环境,以更好地做好未来的准备。在这次审查中,我们系统地分析和分类已开发的数学模型,以设计最初有限疫苗的最佳疫苗优先策略。由于老年人不成比例地受到COVID-19的影响,重点是明确考虑年龄的模型。老年人的流动性和活动水平较低,这引起了不小的权衡。次要研究问题涉及疫苗剂量和空间疫苗分布之间的最佳时间间隔。这篇综述展示了各种建模假设对模型结果的影响。对这些关系的深入了解会产生更好的传染病模型,从而在下一次大流行期间做出公共卫生决策。
    As the world becomes ever more connected, the chance of pandemics increases as well. The recent COVID-19 pandemic and the concurrent global mass vaccine roll-out provides an ideal setting to learn from and refine our understanding of infectious disease models for better future preparedness. In this review, we systematically analyze and categorize mathematical models that have been developed to design optimal vaccine prioritization strategies of an initially limited vaccine. As older individuals are disproportionately affected by COVID-19, the focus is on models that take age explicitly into account. The lower mobility and activity level of older individuals gives rise to non-trivial trade-offs. Secondary research questions concern the optimal time interval between vaccine doses and spatial vaccine distribution. This review showcases the effect of various modeling assumptions on model outcomes. A solid understanding of these relationships yields better infectious disease models and thus public health decisions during the next pandemic.
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  • 文章类型: Observational Study
    目的:难民和移民(R&M)感染COVID-19的风险更高,以及大流行期间更高的死亡率。认识到这些风险,世卫组织将大流行早期的R&M确定为需要保护的优先疫苗接种组。这项研究的目的是评估居住在希腊的接收识别中心(RIC)和接收地点(RSs)的R&M的疫苗接种推广和吸收情况。相对于普通人群。
    方法:全国观察性研究。
    方法:对全国预防接种常规资料和人口普查资料进行回顾性分析,从多个官方/政府来源收集和三角测量。计算了希腊总人口和R&M人口的每周疫苗推广和摄入量,通过希腊疫苗接种计划的第一年(2020年12月至2021年12月)。
    结果:在RIC/RSs的移民中推广疫苗的开始延迟了22周,与一般人口相比。到2021年12月希腊疫苗接种计划的第一年结束时,居住在官方接待设施中的注册R&M中的国家疫苗接种率第一剂为27.3%,加强剂量为4.7%;与普通人群相比,要低得多(第一剂的摄入量为69.5%,第二剂64.7%,第三剂为32.0%)。
    结论:希腊R&M的疫苗推广延迟和疫苗接种率低是R&M疫苗接种策略优先级低和实施失败的迹象。面对未来的公共卫生威胁,应该吸取教训,和疫苗公平应该为所有社会弱势群体和高危人群投保。
    OBJECTIVE: Refugees and migrants (R&Ms) exhibited higher risk of COVID-19 infection, and higher mortality rates during the pandemic. Acknowledging these risks, R&Ms early in the pandemic were identified by WHO as a priority vaccination group in need of protection. The aim of this study was to assess the vaccination roll-out and uptake among R&Ms residing in Reception Identification Centers (RICs) and Reception Sites (RSs) in Greece, relative to the general population.
    METHODS: Nationwide observational study.
    METHODS: Retrospective analysis of national vaccination routine data and population census data, collected and triangulated from multiple official/governmental sources. Weekly vaccine roll-out and uptake were calculated for the general Greek population and the R&M population, through the first year of the vaccination programme in Greece (December 2020-December 2021).
    RESULTS: Vaccine roll-out among migrants in RICs/RSs started with a 22-week delay, compared to the general population. By the end of the first year of the vaccination programme in Greece in December 2021, the national vaccination uptake among registered R&Ms residing in official reception facilities was 27.3 % for 1st dose and 4.7 % for booster dose; considerably lower compared to the general population (69.5 % uptake for 1st dose, 64.7 % for 2nd dose, and 32.0 % for 3rd dose).
    CONCLUSIONS: Delayed vaccine roll-out and low vaccine uptake among R&Ms in Greece are signs of low prioritisation and implementation failures in the R&M vaccination strategy. In face of future public health threats, lessons should be learned, and vaccine equity should be insured for all socially vulnerable and high-risk population groups.
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  • 文章类型: Journal Article
    人们更有可能与自己种族的其他人互动,这种现象被称为种族同质性。在美国,众所周知,有色人种承担着更多的高接触工作,因此更容易感染病毒。同时,这些种族平均比其他人口年轻。这产生了有趣的疾病动态和不平凡的权衡,在制定未来大规模疫苗推广的优先战略时,应该考虑这些权衡。这里,我们研究了COVID-19在美国人群中的传播,按年龄分层,种族,和职业,使用详细的,以前开发的房室疾病模型。根据2020年12月开始的美国大规模COVID-19疫苗推广的历史数据,我们显示,(I)种族同性恋如何影响最佳疫苗分配策略的选择,(ii)尽管存在潜在的道德问题,在这些策略中按种族区分可以改善结果(例如,更少的死亡),以及(iii)美国最有可能的社会环境与不考虑种族的模型所做的标准假设非常不同,并且这种差异会影响哪种分配策略是最佳的。这份手稿是作为“COVID-19建模和未来流行病准备”主题的一部分提交的。
    People are more likely to interact with other people of their ethnicity-a phenomenon known as ethnic homophily. In the United States, people of color are known to hold proportionately more high-contact jobs and are thus more at risk of virus infection. At the same time, these ethnic groups are on average younger than the rest of the population. This gives rise to interesting disease dynamics and non-trivial trade-offs that should be taken into consideration when developing prioritization strategies for future mass vaccine roll-outs. Here, we study the spread of COVID-19 through the US population, stratified by age, ethnicity, and occupation, using a detailed, previously-developed compartmental disease model. Based on historic data from the US mass COVID-19 vaccine roll-out that began in December 2020, we show, (i) how ethnic homophily affects the choice of optimal vaccine allocation strategy, (ii) that, notwithstanding potential ethical concerns, differentiating by ethnicity in these strategies can improve outcomes (e.g., fewer deaths), and (iii) that the most likely social context in the United States is very different from the standard assumptions made by models which do not account for ethnicity and this difference affects which allocation strategy is optimal. This manuscript was submitted as part of a theme issue on \"Modelling COVID-19 and Preparedness for Future Pandemics\".
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  • 文章类型: Journal Article
    自2020年2月尼日利亚报告第一例COVID-19病例以来,该国遏制病例激增和保护人们免受疾病侵害的努力是不可否认的,横河州(CRS)也是如此。使用文档修订,我们展示了COVID-19疫苗在克罗斯河州的推广,尼日利亚。该州于2020年6月29日记录了第一例COVID-19病例。COVID-19疫苗接种于2021年3月11日在该州开始。大流行应对工作由CRS政府于2020年3月成立的COVID-19工作组领导,以确保有效应对有效应对大流行。加强宣传,沟通和社会动员活动,主要是社区参与,是为了尽量减少疫苗的犹豫。在疫苗管理和后勤方面观察到一系列责任。国家成功推出了COVID-19疫苗接种的第一阶段,包括难民疫苗接种和AEFI管理。这篇评论旨在分享在克罗斯河州推出COVID-19疫苗的经验和教训,尼日利亚。本文将指导发展中国家的决策者。
    Since the first COVID-19 case was reported in Nigeria in February 2020, the Country\'s effort to curb the surge in cases and protect people from the disease was undeniable, as does Cross River State (CRS). Using document revision, we illustrate the COVID-19 vaccine rollout in Cross River State, Nigeria. The State recorded its first COVID-19 cases on June 29, 2020. COVID-19 vaccination commenced in the State on March 11, 2021. The pandemic response was led by the COVID -19 taskforce constituted by the Government of CRS in March 2020 to ensure effective response to effective response to the pandemic. Intensified advocacy, communication and social mobilization activities, mainly community engagement, were conducted to minimize vaccine hesitancy. A chain of responsibilities was observed in vaccine management and logistics. The State carried out a successful rollout of the first phase of COVID-19 vaccination, including refugees\' vaccination and management of AEFI. This commentary aims to share the experience and lessons learned in rolling out the COVID-19 vaccine in Cross River State, Nigeria. This paper will guide policymakers in developing countries.
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  • 文章类型: Journal Article
    在COVID-19大流行开始并在世界各地蔓延之后,各国采取了遏制措施来阻止其传播,限制死亡人数,并缓解医院因病毒而造成的紧张和压倒性的条件。许多国家实施了社会疏远和封锁战略,对其经济和公民的心理健康产生了负面影响。尽管他们为拯救生命做出了贡献。最近批准和可用,COVID-19疫苗可以为控制大流行提供真正可行和可持续的选择。然而,由于疫苗犹豫不决和后勤组织障碍,尽管媒体多次呼吁,它们的吸收代表了全球挑战,这些障碍使疫苗在几个发达国家的分销停滞不前,政策制定者和决策者,和社区领袖。疫苗分发也是发展中国家关注的问题,那里的剂量很少。本研究的目的是建立一个指标来评估疫苗接种的吸收,并确定影响该指标的国家社会经济因素。我们进行了一项跨国研究。我们首先通过对报告的每日病例数拟合逻辑模型来估计各国的疫苗接种率。利用吸收率,我们估计了疫苗推广指数。接下来,我们用随机森林,一种“现成的”机器学习算法,研究疫苗接种率与社会经济因素之间的关系。我们发现,平均疫苗推出指数为0.016(标准偏差0.016),范围在0.0001(海地)和0.0829(蒙古)之间。与疫苗推广指数相关的前四个因素是人均收入中位数,人类发展指数,在过去三个月中使用互联网的个人百分比,人均卫生支出。仍在持续的COVID-19大流行揭示了低收入和高收入国家在疫苗采用方面的差距,这代表了全球公共卫生挑战。我们必须为普遍获得疫苗和其他批准的治疗方法铺平道路,无论人口结构和潜在的健康状况。收入差距依然存在,相反,疫苗不公平的一个重要原因,这限制了全球疫苗分配框架的运作,因此,大流行的结束。需要更强有力的机制来促进各国在全球化社会中促进疫苗和药物获取公平的政治意愿,在全球化社会中,可以预见未来的流行病和其他全球健康危机。
    After the start of the COVID-19 pandemic and its spread across the world, countries have adopted containment measures to stop its transmission, limit fatalities, and relieve hospitals from straining and overwhelming conditions imposed by the virus. Many countries implemented social distancing and lockdown strategies that negatively impacted their economies and the psychological wellbeing of their citizens, even though they contributed to saving lives. Recently approved and available, COVID-19 vaccines can provide a really viable and sustainable option for controlling the pandemic. However, their uptake represents a global challenge due to vaccine hesitancy and logistic-organizational hurdles that have made its distribution stagnant in several developed countries despite several appeals by the media, policy- and decision-makers, and community leaders. Vaccine distribution is also a concern in developing countries, where there is a scarcity of doses. The objective of the present study was to set up a metric to assess vaccination uptake and identify national socio-economic factors influencing this indicator. We conducted a cross-country study. We first estimated the vaccination uptake rate across countries by fitting a logistic model to reported daily case numbers. Using the uptake rate, we estimated the vaccine roll-out index. Next, we used Random Forest, an \"off-the-shelf\" machine learning algorithm, to study the association between vaccination uptake rate and socio-economic factors. We found that the mean vaccine roll-out index is 0.016 (standard deviation 0.016), with a range between 0.0001 (Haiti) and 0.0829 (Mongolia). The top four factors associated with the vaccine roll-out index are the median per capita income, human development index, percentage of individuals who have used the internet in the last three months, and health expenditure per capita. The still-ongoing COVID-19 pandemic has shed light on the disparity in vaccine adoption across low- and high-income countries, which represents a global public health challenge. We must pave the way for universal access to vaccines and other approved treatments, regardless of demographic structures and underlying health conditions. Income disparity remains, instead, an important cause of vaccine inequity, which restricts the functioning of the global vaccine allocation framework and, thus, the ending of the pandemic. Stronger mechanisms are needed to foster countries\' political willingness to promote vaccine and drug access equity in a globalized society where future pandemics and other global health crises can be anticipated.
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  • 文章类型: Journal Article
    我们开发了一种基于COVID-19传播动力学模型的随机优化技术,以确定从封锁到重新开放的最佳途径,以不同规模和速度的大规模疫苗推广,以最大限度地提高社会经济活动,同时不压倒整个卫生系统的能力,住院病床,特别是重症监护病房。我们用的是安大略省,加拿大作为案例研究,以演示方法和最佳决策树;但是我们的方法和算法是通用的,可以适应其他设置。我们的模型框架和优化策略考虑了在逐步重新开放过程的不同阶段可能出现的社会交往范围,并考虑了由于个人行为和合规性的变化而导致的这些接触率的不确定性。结果表明,如果没有大规模的疫苗接种,如果在省封锁和居家秩序之后立即采用此策略,则会有多个最佳途径;然而,一旦重新开放比最佳路径中确定的时间更早开始,具有类似约束的最优路径不再存在,可以找到对重症监护病房需求增加的次优途径,但是选择是有限的,途径是狭窄的。我们还模拟了大规模疫苗接种推出后重新开放的情况,我们得出的结论是,鉴于加速的疫苗接种计划,接近大流行前活动水平的最佳途径是可行的,最终的活性水平取决于疫苗覆盖率和主要菌株的传播性。
    We developed a stochastic optimization technology based on a COVID-19 transmission dynamics model to determine optimal pathways from lockdown toward reopening with different scales and speeds of mass vaccine rollout in order to maximize social economical activities while not overwhelming the health system capacity in general, hospitalization beds, and intensive care units in particular. We used the Province of Ontario, Canada as a case study to demonstrate the methodology and the optimal decision trees; but our method and algorithm are generic and can be adapted to other settings. Our model framework and optimization strategies take into account the likely range of social contacts during different phases of a gradual reopening process and consider the uncertainties of these contact rates due to variations of individual behaviors and compliance. The results show that, without a mass vaccination rollout, there would be multiple optimal pathways should this strategy be adopted right after the Province\'s lockdown and stay-at-home order; however, once reopening has started earlier than the timing determined in the optimal pathway, an optimal pathway with similar constraints no longer exists, and sub-optimal pathways with increased demand for intensive care units can be found, but the choice is limited and the pathway is narrow. We also simulated the situation when the reopening starts after the mass vaccination has been rolled out, and we concluded that optimal pathways toward near pre-pandemic activity level is feasible given an accelerated vaccination rollout plan, with the final activity level being determined by the vaccine coverage and the transmissibility of the dominating strain.
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  • 文章类型: Editorial
    COVID-19正在带来巨大的健康,社会和经济成本。虽然许多发达国家已经开始接种疫苗,大多数非洲国家正在等待分配疫苗库存,并正在使用临床公共卫生(CPH)策略来控制大流行。关注变体(VOC)的出现,获得疫苗供应和当地特定后勤和疫苗交付参数的机会不平等,增加了国家CPH战略的复杂性,并扩大了对有效CPH政策的迫切需要。大数据和人工智能机器学习技术和协作可以有助于准确、及时,对多个数据源进行局部细致入微的分析,为CPH决策提供信息,疫苗接种策略及其分阶段推广。非洲-加拿大人工智能和数据创新联盟(ACADIC)已经成立,旨在开发和采用机器学习技术来设计非洲的CPH战略。这需要持续的合作,测试和开发,以最大限度地提高与COVID-19相关的CPH干预措施的公平性和有效性。
    COVID-19 is imposing massive health, social and economic costs. While many developed countries have started vaccinating, most African nations are waiting for vaccine stocks to be allocated and are using clinical public health (CPH) strategies to control the pandemic. The emergence of variants of concern (VOC), unequal access to the vaccine supply and locally specific logistical and vaccine delivery parameters, add complexity to national CPH strategies and amplify the urgent need for effective CPH policies. Big data and artificial intelligence machine learning techniques and collaborations can be instrumental in an accurate, timely, locally nuanced analysis of multiple data sources to inform CPH decision-making, vaccination strategies and their staged roll-out. The Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC) has been established to develop and employ machine learning techniques to design CPH strategies in Africa, which requires ongoing collaboration, testing and development to maximize the equity and effectiveness of COVID-19-related CPH interventions.
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