香港欧米克隆ba2流行期间疫苗接种政策优化的回顾性评估：一项模型研究。

IF 4 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-09-12 DOI:10.1016/j.jiph.2025.102972

Benjamin R. Young , Faith Ho , Yun Lin , Eric H.Y. Lau , Peng Wu , Benjamin J. Cowling , Tim K. Tsang

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引用次数: 0

摘要

背景：次优的COVID-19疫苗分配阻碍了其潜在的疾病保护作用。2022年，在接种疫苗一年多后，香港爆发了乙型流感，造成了流感大流行中最高的日死亡率之一。方法：我们开发了一个年龄和剂量结构的SEIR模型来描述这种流行病的传播动力学。然后，我们将模型拟合到严重疾病数据中，通过贝叶斯推理来估计流行病的传播动态。之后，我们基于拟合的传播动力学进行了广泛的反事实模拟，并考虑了不同年龄特异性疫苗接种覆盖率和时间，以估计不同情景下对严重疾病的影响。结果：如果80岁以上个体的主要系列覆盖范围与成人人群相似，则可以避免27.6% %（95% %后检预测区间[PPI]: 24.7 %,31.1% %）的死亡。40-49岁人群的高初级系列覆盖率避免了32.6% %（95% % PPI: 30.0% %,35.5% %）的住院。将成人或老年人疫苗接种运动提前两周显著减少死亡人数，分别为498人（95 % PPI: 309, 688）和601人（95 % PPI: 412, 792）。儿童早期接种疫苗对人口死亡没有显著影响。结论：老年人初级系列的低覆盖率导致了大多数可预防的死亡，而中年群体的高覆盖率显著避免了过多的住院治疗。我们的研究强调了在高风险和传播驱动人群中针对COVID-19疫苗接种的重要性，以及疫苗接种的时间敏感性，每周的差异可以避免或助长发病率和死亡率。

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Retrospective assessment of vaccination policy optimizations during an Omicron BA.2 epidemic in Hong Kong: A modelling study

Background

Suboptimal COVID-19 vaccine distribution hampers their potential disease protection impact. The 2022 BA.2 epidemic in Hong Kong, occurring over a year into vaccination efforts, resulted in one of the highest daily mortality rates of the pandemic.

Methods

We developed an age- and dose-structured SEIR model to describe the transmission dynamics in this epidemic. Then we fitted the model to severe disease data to estimate the transmission dynamics of the epidemics by Bayesian inference. After that, we conducted extensive counterfactual simulations based on the fitted transmission dynamics and considered varying age-specific vaccination coverages and timing to estimate the impact on severe disease across scenarios.

Results

If individuals over 80 had primary series coverage similar to the adult population, 27.6 % (95 % posterior predictive interval [PPI]: 24.7 %, 31.1 %) of deaths could have been averted. High primary series coverage in 40–49-year-olds averted 32.6 % (95 % PPI: 30.0 %, 35.5 %) more hospitalisations. Advancing the adult or senior vaccination campaign by two weeks significantly reduced deaths by 498 (95 % PPI: 309, 688) and 601 (95 % PPI: 412, 792), respectively. Earlier vaccination of children had no significant impact on population-wide deaths.

Conclusions

Low elderly primary series coverage led to the most preventable deaths, while high coverage in middle-aged groups significantly averted excess hospitalisations. Our study underscores the importance of targeting COVID-19 vaccinations in high-risk and transmission-driving groups, as well as vaccination time-sensitivity, where each week difference, averts or abets morbidity and mortality.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.