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Importance of COVID-19 vaccine efficacy in older age groups

An effective vaccine against SARS-CoV-2 will reduce morbidity and mortality and allow substantial relaxation of physical distancing policies. However, the ability of a vaccine to prevent infection or disease depends critically on protecting older individuals, who are at highest risk of severe diseas... Full description

Journal Title: Vaccine 2021-04-08, Vol.39 (15), p.2020-2023
Main Author: Sadarangani, Manish
Other Authors: Abu Raya, Bahaa , Conway, Jessica M , Iyaniwura, Sarafa A , Falcao, Rebeca Cardim , Colijn, Caroline , Coombs, Daniel , Gantt, Soren
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
Publisher: Netherlands: Elsevier Ltd
ID: ISSN: 0264-410X
Link: https://www.ncbi.nlm.nih.gov/pubmed/33736921
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recordid: cdi_proquest_miscellaneous_2503436937
title: Importance of COVID-19 vaccine efficacy in older age groups
format: Article
creator:
  • Sadarangani, Manish
  • Abu Raya, Bahaa
  • Conway, Jessica M
  • Iyaniwura, Sarafa A
  • Falcao, Rebeca Cardim
  • Colijn, Caroline
  • Coombs, Daniel
  • Gantt, Soren
subjects:
  • Adults
  • Age
  • Age Factors
  • Age-structured effectiveness
  • Aged
  • Analysis
  • British Columbia
  • Coronaviruses
  • COVID-19
  • COVID-19 - prevention & control
  • Covid-19 disease
  • Covid-19 vaccine
  • COVID-19 vaccines
  • COVID-19 Vaccines - immunology
  • Disease prevention
  • Disease transmission
  • Effectiveness
  • Epidemics
  • Fatalities
  • Health risks
  • Humans
  • Infections
  • Influenza
  • Mathematical analysis
  • Mathematical model
  • Mathematical models
  • Morbidity
  • Mortality
  • Older people
  • Pandemics
  • Population
  • Severe acute respiratory syndrome coronavirus 2
  • Short Communication
  • Vaccination
  • Vaccines
  • Viral diseases
ispartof: Vaccine, 2021-04-08, Vol.39 (15), p.2020-2023
description: An effective vaccine against SARS-CoV-2 will reduce morbidity and mortality and allow substantial relaxation of physical distancing policies. However, the ability of a vaccine to prevent infection or disease depends critically on protecting older individuals, who are at highest risk of severe disease. We quantitatively estimated the relative benefits of COVID-19 vaccines, in terms of preventing infection and death, with a particular focus on effectiveness in elderly people. We applied compartmental mathematical modelling to determine the relative effects of vaccines that block infection and onward transmission, and those that prevent severe disease. We assumed that vaccines showing high efficacy in adults would be deployed, and examined the effects of lower vaccine efficacy among the elderly population. Our mathematical model was calibrated to simulate the course of an epidemic among the entire population of British Columbia, Canada. Within our model, the population was structured by age and levels of contact. We assessed the effectiveness of possible vaccines in terms of the predicted number of infections within the entire population, and deaths among people aged 65 years and over. In order to reduce the overall rate of infections in the population, high rates of deployment to all age groups will be critical. However, to substantially reduce mortality among people aged 65 years and over, a vaccine must directly protect a high proportion of people in that group. Effective vaccines deployed to a large fraction of the population are projected to substantially reduce infection in an otherwise susceptible population. However, even if transmission were blocked highly effectively by vaccination of children and younger adults, overall mortality would not be substantially reduced unless the vaccine is also directly protective in elderly people. We strongly recommend: (i) the inclusion of people aged 65 years and over in future trials of COVID-19 vaccine candidates; (ii) careful monitoring of vaccine efficacy in older age groups following vaccination.
language: eng
source:
identifier: ISSN: 0264-410X
fulltext: no_fulltext
issn:
  • 0264-410X
  • 1873-2518
url: Link


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descriptionAn effective vaccine against SARS-CoV-2 will reduce morbidity and mortality and allow substantial relaxation of physical distancing policies. However, the ability of a vaccine to prevent infection or disease depends critically on protecting older individuals, who are at highest risk of severe disease. We quantitatively estimated the relative benefits of COVID-19 vaccines, in terms of preventing infection and death, with a particular focus on effectiveness in elderly people. We applied compartmental mathematical modelling to determine the relative effects of vaccines that block infection and onward transmission, and those that prevent severe disease. We assumed that vaccines showing high efficacy in adults would be deployed, and examined the effects of lower vaccine efficacy among the elderly population. Our mathematical model was calibrated to simulate the course of an epidemic among the entire population of British Columbia, Canada. Within our model, the population was structured by age and levels of contact. We assessed the effectiveness of possible vaccines in terms of the predicted number of infections within the entire population, and deaths among people aged 65 years and over. In order to reduce the overall rate of infections in the population, high rates of deployment to all age groups will be critical. However, to substantially reduce mortality among people aged 65 years and over, a vaccine must directly protect a high proportion of people in that group. Effective vaccines deployed to a large fraction of the population are projected to substantially reduce infection in an otherwise susceptible population. However, even if transmission were blocked highly effectively by vaccination of children and younger adults, overall mortality would not be substantially reduced unless the vaccine is also directly protective in elderly people. We strongly recommend: (i) the inclusion of people aged 65 years and over in future trials of COVID-19 vaccine candidates; (ii) careful monitoring of vaccine efficacy in older age groups following vaccination.
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subjectAdults ; Age ; Age Factors ; Age-structured effectiveness ; Aged ; Analysis ; British Columbia ; Coronaviruses ; COVID-19 ; COVID-19 - prevention & control ; Covid-19 disease ; Covid-19 vaccine ; COVID-19 vaccines ; COVID-19 Vaccines - immunology ; Disease prevention ; Disease transmission ; Effectiveness ; Epidemics ; Fatalities ; Health risks ; Humans ; Infections ; Influenza ; Mathematical analysis ; Mathematical model ; Mathematical models ; Morbidity ; Mortality ; Older people ; Pandemics ; Population ; Severe acute respiratory syndrome coronavirus 2 ; Short Communication ; Vaccination ; Vaccines ; Viral diseases
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abstractAn effective vaccine against SARS-CoV-2 will reduce morbidity and mortality and allow substantial relaxation of physical distancing policies. However, the ability of a vaccine to prevent infection or disease depends critically on protecting older individuals, who are at highest risk of severe disease. We quantitatively estimated the relative benefits of COVID-19 vaccines, in terms of preventing infection and death, with a particular focus on effectiveness in elderly people. We applied compartmental mathematical modelling to determine the relative effects of vaccines that block infection and onward transmission, and those that prevent severe disease. We assumed that vaccines showing high efficacy in adults would be deployed, and examined the effects of lower vaccine efficacy among the elderly population. Our mathematical model was calibrated to simulate the course of an epidemic among the entire population of British Columbia, Canada. Within our model, the population was structured by age and levels of contact. We assessed the effectiveness of possible vaccines in terms of the predicted number of infections within the entire population, and deaths among people aged 65 years and over. In order to reduce the overall rate of infections in the population, high rates of deployment to all age groups will be critical. However, to substantially reduce mortality among people aged 65 years and over, a vaccine must directly protect a high proportion of people in that group. Effective vaccines deployed to a large fraction of the population are projected to substantially reduce infection in an otherwise susceptible population. However, even if transmission were blocked highly effectively by vaccination of children and younger adults, overall mortality would not be substantially reduced unless the vaccine is also directly protective in elderly people. We strongly recommend: (i) the inclusion of people aged 65 years and over in future trials of COVID-19 vaccine candidates; (ii) careful monitoring of vaccine efficacy in older age groups following vaccination.
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