Comparative performance of between-population vaccine allocation strategies with applications for emerging pandemics.

Vaccine allocation decisions during emerging pandemics have proven to be challenging due to competing ethical, practical, and political considerations. Complicating decision making, policy makers need to consider vaccine allocation strategies that balance needs both within and between populations. When vaccine stockpiles are limited, doses should be allocated in locations to maximize their impact. Using a susceptible-exposed-infectious-recovered (SEIR) model we examine optimal vaccine allocation decisions across two populations considering the impact of characteristics of the population (e.g., size, underlying immunity, heterogeneous risk structure, interaction), vaccine (e.g., vaccine efficacy), pathogen (e.g., transmissibility), and delivery (e.g., varying speed and timing of rollout). Across a wide range of characteristics considered, we find that vaccine allocation proportional to population size (i.e., pro-rata allocation) performs either better or comparably to nonproportional allocation strategies in minimizing the cumulative number of infections. These results may argue in favor of sharing of vaccines between locations in the context of an epidemic caused by an emerging pathogen, where many epidemiologic characteristics may not be known.

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Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Eva Rumpler, Lee Kennedy-Shaffer, and Rafia Bosan have no conflicts of interest to disclose. Keya Joshi reports a paid internship unrelated to COVID-19 with Janssen Pharmaceuticals. Marc Lipsitch reports grants from CDC, NIH, UK NIHR, and Pfizer, personal fees from Merck, Janssen, Sanofi Pasteur, Bristol Myers Squibb, and Peter Diamandis/Abundance Platinum, outside the submitted work; and Unpaid advice to One Day Sooner, Pfizer, Janssen, Astra-Zeneca, COVAX (United Biomedical).