Low-and middle-income countries faced significant challenges in accessing COVID-19 vaccines during the early stages of the pandemic.In this study,we utilized an agestructured modeling approach to examine the implicati...Low-and middle-income countries faced significant challenges in accessing COVID-19 vaccines during the early stages of the pandemic.In this study,we utilized an agestructured modeling approach to examine the implications of various vaccination strategies,vaccine prioritization,and vaccine rollout speeds in Thailand,an upper-middleincome country experiencing vaccine shortages during the early stages of the pandemic.The model directly compares the effectiveness of several vaccination strategies,including the heterologous vaccination where CoronaVac(CV)vaccine was administered as the first dose,followed by ChAdOx1 nCoV-19(AZ)vaccine as the second dose,under varying disease transmission dynamics.We found that the traditional AZ homologous vaccination was more effective than the CV homologous vaccination,regardless of disease transmission dynamics.However,combining CV and AZ vaccines via either parallel homologous or heterologous vaccinations was more effective than relying solely on AZ homologous vaccination.Additionally,prioritizing vaccination for the elderly aged 60 years and above was the most effective way to reduce mortality when community transmission is wellcontrolled.On the other hand,prioritizing workers aged 20e59 was most effective in lowering COVID-19 cases,irrespective of the transmission dynamics.Lastly,despite the vaccine prioritization strategy,rapid vaccine rollout speeds were crucial in reducing COVID-19 infections and deaths.These findings suggested that in low-and middle-income countries where early access to high-efficacy vaccines might be limited,obtaining any accessible vaccines as early as possible and using them in parallel with other higherefficacy vaccines might be a better strategy than waiting for and relying solely on higher-efficacy vaccines.展开更多
文摘Low-and middle-income countries faced significant challenges in accessing COVID-19 vaccines during the early stages of the pandemic.In this study,we utilized an agestructured modeling approach to examine the implications of various vaccination strategies,vaccine prioritization,and vaccine rollout speeds in Thailand,an upper-middleincome country experiencing vaccine shortages during the early stages of the pandemic.The model directly compares the effectiveness of several vaccination strategies,including the heterologous vaccination where CoronaVac(CV)vaccine was administered as the first dose,followed by ChAdOx1 nCoV-19(AZ)vaccine as the second dose,under varying disease transmission dynamics.We found that the traditional AZ homologous vaccination was more effective than the CV homologous vaccination,regardless of disease transmission dynamics.However,combining CV and AZ vaccines via either parallel homologous or heterologous vaccinations was more effective than relying solely on AZ homologous vaccination.Additionally,prioritizing vaccination for the elderly aged 60 years and above was the most effective way to reduce mortality when community transmission is wellcontrolled.On the other hand,prioritizing workers aged 20e59 was most effective in lowering COVID-19 cases,irrespective of the transmission dynamics.Lastly,despite the vaccine prioritization strategy,rapid vaccine rollout speeds were crucial in reducing COVID-19 infections and deaths.These findings suggested that in low-and middle-income countries where early access to high-efficacy vaccines might be limited,obtaining any accessible vaccines as early as possible and using them in parallel with other higherefficacy vaccines might be a better strategy than waiting for and relying solely on higher-efficacy vaccines.
