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新冠病毒肺炎疫苗分配 ——模拟可替代策略的健康结局和公正性影响
Maddalena Ferranna, Daniel Cadarette, David E. Bloom
工程（英文） ›› 2021, Vol. 7 ›› Issue (7) : 924-935.
PDF(1430 KB)
PDF(1430 KB)
新冠病毒肺炎疫苗分配 ——模拟可替代策略的健康结局和公正性影响
COVID-19 Vaccine Allocation: Modeling Health Outcomes and Equity Implications of Alternative Strategies
鉴于缺乏安全有效的新冠病毒肺炎（COVID-19）疫苗，一个主要的政策问题是如何在不同的社会人口学特征群体中分配疫苗。本文评估了迄今为止提出的COVID-19疫苗优先策略，重点关注其既定目标；所选分配方案对于大流行病进程和负担的影响机制；以及制定优先策略时出现的流行病学、经济、后勤和政治等主要问题。本文将一个简洁、按年龄分层的易感-暴露-感染-恢复模型应用于美国，以定量评估替代优先策略在保护死亡、保护感染和延长寿命方面的表现。我们证明了优先考虑重点岗位人群是减少病例数量和降低死亡损失生命年的可行策略，而在大多数情况下，通过优先考虑老年人来实现死亡人数的最大减少，即使疫苗能有效阻止病毒传播。这一特性的不确定性和疫苗针剂支付的潜在延迟加强了优先考虑老年人的呼吁。此外，我们还调查了支持分配策略的公平动机的强度，该策略将绝对优先考虑给予重点岗位人群能降低感染致死风险的疫苗。
Given the scarcity of safe and effective COVID-19 vaccines, a chief policy question is how to allocate them among different sociodemographic groups. This paper evaluates COVID-19 vaccine prioritization strategies proposed to date, focusing on their stated goals; the mechanisms through which the selected allocations affect the course and burden of the pandemic; and the main epidemiological, economic, logistical, and political issues that arise when setting the prioritization strategy. The paper uses a simple, agestratified susceptible–exposed–infectious–recovered model applied to the United States to quantitatively assess the performance of alternative prioritization strategies with respect to avoided deaths, avoided infections, and life-years gained. We demonstrate that prioritizing essential workers is a viable strategy for reducing the number of cases and years of life lost, while the largest reduction in deaths is achieved by prioritizing older adults in most scenarios, even if the vaccine is effective at blocking viral transmission. Uncertainty regarding this property and potential delays in dose delivery reinforce the call for prioritizing older adults. Additionally, we investigate the strength of the equity motive that would support an allocation strategy attaching absolute priority to essential workers for a vaccine that reduces infectionfatality risk.
疫苗分配 / COVID-19 / 公正性 / SEIR模型
Vaccine allocation / COVID-19 / Equity / SEIR model
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