{"title":"流动性、免疫力和疫苗接种对多米尼加共和国 SARS-CoV-2 传播的影响:模拟研究","authors":"","doi":"10.1016/j.lana.2024.100860","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>COVID-19 dynamics are driven by a complex interplay of factors including population behaviour, new variants, vaccination and immunity from prior infections. We quantify drivers of SARS-CoV-2 transmission in the Dominican Republic, an upper-middle income country of 10.8 million people. We then assess the impact of the vaccination campaign implemented in February 2021, primarily using CoronaVac, in saving lives and averting hospitalisations.</p></div><div><h3>Methods</h3><p>We fit an age-structured, multi-variant transmission dynamic model to reported deaths, hospital bed occupancy, and seroprevalence data until December 2021, and simulate epidemic trajectories under different counterfactual scenarios.</p></div><div><h3>Findings</h3><p>We estimate that vaccination averted 7210 hospital admissions (95% credible interval, CrI: 6830–7600), 2180 intensive care unit admissions (95% CrI: 2080–2280) and 766 deaths (95% CrI: 694–859) in the first 6 months of the campaign. If no vaccination had occurred, we estimate that an additional decrease of 10–20% in population mobility would have been required to maintain equivalent death and hospitalisation outcomes. We also found that early vaccination with CoronaVac was preferable to delayed vaccination using a product with higher efficacy.</p></div><div><h3>Interpretation</h3><p>SARS-CoV-2 transmission dynamics in the Dominican Republic were driven by a substantial accumulation of immunity during the first two years of the pandemic but, despite this, vaccination was essential in enabling a return to pre-pandemic mobility levels without considerable additional morbidity and mortality.</p></div><div><h3>Funding</h3><p><span>Medical Research Council</span>, <span>Wellcome Trust</span>, <span>Royal Society</span>, <span>US CDC</span> and Australian <span>National Health and Medical Research Council</span>.</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X2400187X/pdfft?md5=97443b4e7e5bd7d4ce03d546e8419abe&pid=1-s2.0-S2667193X2400187X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Effects of mobility, immunity and vaccination on SARS-CoV-2 transmission in the Dominican Republic: a modelling study\",\"authors\":\"\",\"doi\":\"10.1016/j.lana.2024.100860\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>COVID-19 dynamics are driven by a complex interplay of factors including population behaviour, new variants, vaccination and immunity from prior infections. We quantify drivers of SARS-CoV-2 transmission in the Dominican Republic, an upper-middle income country of 10.8 million people. We then assess the impact of the vaccination campaign implemented in February 2021, primarily using CoronaVac, in saving lives and averting hospitalisations.</p></div><div><h3>Methods</h3><p>We fit an age-structured, multi-variant transmission dynamic model to reported deaths, hospital bed occupancy, and seroprevalence data until December 2021, and simulate epidemic trajectories under different counterfactual scenarios.</p></div><div><h3>Findings</h3><p>We estimate that vaccination averted 7210 hospital admissions (95% credible interval, CrI: 6830–7600), 2180 intensive care unit admissions (95% CrI: 2080–2280) and 766 deaths (95% CrI: 694–859) in the first 6 months of the campaign. If no vaccination had occurred, we estimate that an additional decrease of 10–20% in population mobility would have been required to maintain equivalent death and hospitalisation outcomes. We also found that early vaccination with CoronaVac was preferable to delayed vaccination using a product with higher efficacy.</p></div><div><h3>Interpretation</h3><p>SARS-CoV-2 transmission dynamics in the Dominican Republic were driven by a substantial accumulation of immunity during the first two years of the pandemic but, despite this, vaccination was essential in enabling a return to pre-pandemic mobility levels without considerable additional morbidity and mortality.</p></div><div><h3>Funding</h3><p><span>Medical Research Council</span>, <span>Wellcome Trust</span>, <span>Royal Society</span>, <span>US CDC</span> and Australian <span>National Health and Medical Research Council</span>.</p></div>\",\"PeriodicalId\":29783,\"journal\":{\"name\":\"Lancet Regional Health-Americas\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":7.0000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2667193X2400187X/pdfft?md5=97443b4e7e5bd7d4ce03d546e8419abe&pid=1-s2.0-S2667193X2400187X-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Lancet Regional Health-Americas\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2667193X2400187X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lancet Regional Health-Americas","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2667193X2400187X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Effects of mobility, immunity and vaccination on SARS-CoV-2 transmission in the Dominican Republic: a modelling study
Background
COVID-19 dynamics are driven by a complex interplay of factors including population behaviour, new variants, vaccination and immunity from prior infections. We quantify drivers of SARS-CoV-2 transmission in the Dominican Republic, an upper-middle income country of 10.8 million people. We then assess the impact of the vaccination campaign implemented in February 2021, primarily using CoronaVac, in saving lives and averting hospitalisations.
Methods
We fit an age-structured, multi-variant transmission dynamic model to reported deaths, hospital bed occupancy, and seroprevalence data until December 2021, and simulate epidemic trajectories under different counterfactual scenarios.
Findings
We estimate that vaccination averted 7210 hospital admissions (95% credible interval, CrI: 6830–7600), 2180 intensive care unit admissions (95% CrI: 2080–2280) and 766 deaths (95% CrI: 694–859) in the first 6 months of the campaign. If no vaccination had occurred, we estimate that an additional decrease of 10–20% in population mobility would have been required to maintain equivalent death and hospitalisation outcomes. We also found that early vaccination with CoronaVac was preferable to delayed vaccination using a product with higher efficacy.
Interpretation
SARS-CoV-2 transmission dynamics in the Dominican Republic were driven by a substantial accumulation of immunity during the first two years of the pandemic but, despite this, vaccination was essential in enabling a return to pre-pandemic mobility levels without considerable additional morbidity and mortality.
Funding
Medical Research Council, Wellcome Trust, Royal Society, US CDC and Australian National Health and Medical Research Council.
期刊介绍:
The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.