Prioritizing older adults for the COVID-19 vaccine will save more lives

Older adult vaccination for COVID-19 will save lives much more than in the US than prioritizing other age groups, and the slower the spread of the vaccine and the wider the spread of the virus, the more important it becomes. bring them to the front of the line.

That’s one major takeaway from the University of Colorado Boulder newspaper, published today in the journal Science, which uses mathematical modeling to make predictions about how different distribution strategies would play out in countries around the world.

The research has already informed policy recommendations by the Centers for Disease Control and the World Health Organization to prioritize older adults after medical staff.

Now, as policymakers decide how and whether to carry out that advice, the paper – which contains an interactive tool – shows the numbers behind it. ‘hard decision.

Common sense would suggest that you want to protect the oldest, most vulnerable in the population first. But common sense also suggests that you want to protect critical employees at the outset (such as grocery clerks and teachers) who are at higher risk of being exposed. When common sense leads you in two different directions, mathematics can help you make a decision. “

Daniel Larremore, Lead Author, Computational Biologist, Department of Computer Science and CU Boulder BioFrontiers Institute

For the study, Larremore and lead author Kate Bubar, a graduate student in the Department of Applied Mathematics, joined colleagues at the Harvard TH Chan School of Public Health and the University of Chicago.

They drew on demographic information from different countries, as well as updated data on how many people have tested positive for COVID-19, how fast the virus spreads, how quickly vaccines are distributed and the estimated effect.

They then modeled what would happen in five different situations in which a different group first received the vaccine: Children and adolescents; adults ages 20 to 49; adults 20 or older; or adults 60 or older (assuming that about 30% of those eligible may decline). In the fifth case, anyone who wanted a vaccine received one while the supply lasted.

Results from the United States, Belgium, Brazil, China, India, Poland, South Africa, Spain and Zimbabwe are included in the paper, with more countries being included. into the online tool.

Different strategies worked better or worse, depending on the local situation, but a few key decisions jumped out.

In most cases, across countries, prioritizing adults 60+ saved most of their lives.

“Age is the strongest predictor of vulnerability,” Larremore said, noting that while pre-existing conditions such as asthma increase the risk of serious illness or death, age promotes greater vulnerability. “You have a higher chance of dying from COVID-19 as you get older.”

The authors also note that while it is believed that about 90 to 95% of the vaccines now being circulated are for protection against serious disease, unknowns are unknown. -researches how well they prevent infection and transmission. If they do not prevent it well and there are asymptomatic scatterers, it again makes sense to vaccinate older adults. If nothing else, they will be personally protected from grave disease.

It is only in situations where the virus is under control and where the vaccine is known to inhibit infection and spread well does it make sense to move younger adults to the front of the line. That is not the case in the United States at the moment.

“For critical employees who may be sad that they are not first, we hope this study offers some clarity,” Bubar said. “We realize it’s a huge sacrifice for them to make but our research shows it will save lives. “

So spread will be faster, they found.

For example, by doing all other things equally, if the roll speed were doubled from normal levels under the normal release conditions, COVID-19 mortality could be reduced by approx. at 23%, or 65,000 lives, over the next three months.

The paper also suggests that, in some cases where COVID is already high in the population and vaccines are scarce, it may be prudent to ask younger adults who have tested positive to go backwards. the line.

“Our research suggests that prioritizing people who have not yet received COVID may allow hardy communities to extend these initial doses further and possibly access some of the herd defense effects more quickly,” Larremore said. .

The authors confirm that vaccinations alone are not the only mechanism to help win the race against COVID.

“To allow the vaccine to reach humans before the virus spreads, we need to not only get the vaccine out quickly and give it to the most vulnerable people. We also need to keep our foot on the virus brake with masks, speed and smart policies, ”Larremore said.