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Vaccinating Children Against COVID-19 is Essential Prior to the Removal of Non-Pharmaceutical Interventions.

ABSTRACT: To evaluate the joint impact of childhood vaccination rates and masking policies, in schools and workplaces, on community transmission and severe outcomes due to COVID-19. We utilized a stochastic, agent-based simulation of North Carolina, to evaluate the impact of 24 health policy decisions on overall incidence of disease, COVID-19 related hospitalization, and mortality from July 1, 2021-July 1, 2023. Universal mask removal in schools in January 2022 could lead to a 38.1-47%, 27.6-36.2%, and 15.9-19.7% increase in cumulative infections for ages 5-9, 10-19, and the total population, respectively, depending on the rate of vaccination of children relative to the adult population. Additionally, without increased vaccination uptake in the adult population, a 25% increase in child vaccination uptake from 50% to 75% uptake and from 75% to 100% uptake relative to the adult population, leads to a 22% and 18% or 28% and 33% decrease in peak hospitalizations in 2022 across scenarios when masks are removed either January 1st or March 8th 2022, respectively. Increasing vaccination uptake for the entire eligible population can reduce peak hospitalizations in 2022 by an average of 89% and 92% across all masking scenarios compared to the scenarios where no children are vaccinated. High vaccination uptake among both children and adults is necessary to mitigate the increase in infections from mask removal in schools and workplaces.

SUBMITTER: Rosenstrom E

PROVIDER: S-EPMC8669851 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Vaccinating Children Against COVID-19 is Essential Prior to the Removal of Non-Pharmaceutical Interventions.

Rosenstrom Erik E Mele Jessica J Ivy Julie J Mayorga Maria M Patel Mehul M Lich Kristen Hassmiller KH Delamater Paul P Smith Raymond R Swann Julie L JL

medRxiv : the preprint server for health sciences 20211209

<h4>Objectivess</h4>To evaluate the joint impact of childhood vaccination rates and masking policies, in schools and workplaces, on community transmission and severe outcomes due to COVID-19.<h4>Study design</h4>We utilized a stochastic, agent-based simulation of North Carolina, to evaluate the impact of 24 health policy decisions on overall incidence of disease, COVID-19 related hospitalization, and mortality from July 1, 2021-July 1, 2023.<h4>Results</h4>Universal mask removal in schools in Ja ...[more]

PMID: 34909784

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Project description:BackgroundIn countries with high COVID-19 vaccination rates the SARS-CoV-2 Delta variant resulted in rapidly increasing case numbers. This study evaluated the use of non-pharmaceutical interventions (NPIs) coupled with alternative vaccination strategies to determine feasible Delta mitigation strategies for Australia. We aimed to understand the potential effectiveness of high vaccine coverage levels together with NPI physical distancing activation and to establish the benefit of adding children and adolescents to the vaccination program. Border closure limited SARS-CoV-2 transmission in Australia; however, slow vaccination uptake resulted in Delta outbreaks in the two largest cities and may continue as international travel increases.MethodsAn agent-based model was used to evaluate the potential reduction in the COVID-19 health burden resulting from alternative vaccination strategies. We assumed immunity was derived from vaccination with the BNT162b2 Pfizer BioNTech vaccine. Two age-specific vaccination strategies were evaluated, ages 5 and above, and 12 and above, and the health burden determined under alternative vaccine coverages, with/without activation of NPIs. Age-specific infections generated by the model, together with recent UK data, permitted reductions in the health burden to be quantified.ResultsCases, hospitalisations and deaths are shown to reduce by (i) increasing coverage to include children aged 5 to 11 years, (ii) activating moderate NPI measures and/or (iii) increasing coverage levels above 80%. At 80% coverage, vaccinating ages 12 and above without NPIs is predicted to result in 1095 additional hospitalisations per million population; adding ages 5 and above reduces this to 996 per million population. Activating moderate NPIs reduces hospitalisations to 611 for ages 12 and over, and 382 per million for ages 5 and above. Alternatively, increasing coverage to 90% for those aged 12 and above is estimated to reduce hospitalisations to 616. Combining all three measures is shown to reduce cases to 158, hospitalisations to 1 and deaths to zero, per million population.ConclusionsDelta variant outbreaks may be managed by vaccine coverage rates higher than 80% and activation of moderate NPI measures, preventing healthcare facilities from being overwhelmed. If 90% coverage cannot be achieved, including young children and adolescents in the vaccination program coupled with activation of moderate NPIs appears necessary to suppress future COVID-19 Delta-like transmission and prevent intensive care unit surge capacity from being exceeded.

Project description:With the recent licensure of mRNA vaccines against COVID-19 in the 5- to 11-year-old age group, the public health impact of a childhood immunization campaign is of interest. Using a mathematical epidemiological model, we project that childhood vaccination carries minimal risk and yields modest public health benefits. These include large relative reductions in child morbidity and mortality, although the absolute reduction is small because these events are rare. Furthermore, the model predicts "altruistic" absolute reductions in adult cases, hospitalizations, and mortality. However, vaccinating children to benefit adults should be considered from an ethical as well as a public health perspective. From a global health perspective, an additional ethical consideration is the justice of giving priority to children in high-income settings at low risk of severe disease while vaccines have not been made available to vulnerable adults in low-income settings. IMPORTANCE Countries have recently begun implementation of childhood vaccination against SARS-CoV-2 with the Pfizer/BioNTech mRNA vaccine in children 5 to 11 years of age. Because SARS-CoV-2 disease severity is remarkably age dependent, vaccinating children may have modest public health benefits, relative to the unequivocal benefit of vaccinating vulnerable older adults. Furthermore, vaccinating children to "altruistically" increase herd immunity should be considered from an ethical as well as a public health perspective. An additional question is related to global social justice: should priority be given to vaccinating children in high-income settings while older adult populations in low-resource settings have limited access to vaccine? To address the risks and benefits of childhood vaccination, we provide a balanced commentary, supported by a mathematical epidemiological model, using Australia and Alberta, Canada, as case studies. We give highlights of the modeling findings in the commentary and include details in the supplemental materials for interested readers.

Project description:ObjectivesThe resurgence in cases and deaths due to COVID-19 in many countries suggests complacency in adhering to COVID-19 preventive guidelines. Vaccination, therefore, remains a key intervention in mitigating the impact of the COVID-19 pandemic. This study investigated the level of adherence to COVID-19 preventive measures and intention to receive the COVID-19 vaccine among Ugandans.Design, setting and participantsA nationwide cross-sectional survey of 1053 Ugandan adults was conducted in March 2021 using telephone interviews.Main outcome measuresParticipants reported on adherence to COVID-19 preventive measures and intention to be vaccinated with COVID-19 vaccines.ResultsOverall, 10.2% of the respondents adhered to the COVID-19 preventive guidelines and 57.8% stated definite intention to receive a SARS-CoV-2 vaccine. Compared with women, men were less likely to adhere to COVID-19 guidelines (Odds Ratio (OR)=0.64, 95% CI 0.41 to 0.99). Participants from the northern (4.0%, OR=0.28, 95% CI 0.12 to 0.92), western (5.1%, OR=0.30, 95% CI 0.14 to 0.65) and eastern regions (6.5%, OR=0.47, 95% CI 0.24 to 0.92), respectively, had lower odds of adhering to the COVID-19 guidelines than those from the central region (14.7%). A higher monthly income of ≥US$137 (OR=2.31, 95% CI 1.14 to 4.58) and a history of chronic disease (OR=1.81, 95% CI 1.14 to 2.86) were predictors of adherence. Concerns about the chances of getting COVID-19 in the future (Prevalence Ratio (PR)=1.26, 95% CI 1.06 to 1.48) and fear of severe COVID-19 infection (PR=1.20, 95% CI 1.04 to 1.38) were the strongest predictors for a definite intention, while concerns for side effects were negatively associated with vaccination intent (PR=0.75, 95% CI 0.68 to 0.83).ConclusionBehaviour change programmes need to be strengthened to promote adherence to COVID-19 preventive guidelines as vaccination is rolled out as another preventive measure. Dissemination of accurate, safe and efficacious information about the vaccines is necessary to enhance vaccine uptake.

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Vaccinating Children Against COVID-19 is Essential Prior to the Removal of Non-Pharmaceutical Interventions.

Publications

Vaccinating Children Against COVID-19 is Essential Prior to the Removal of Non-Pharmaceutical Interventions.

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