Modeling the use of SARS-CoV-2 vaccination to safely relax non-pharmaceutical interventions

• Type of Material: Article
• Authors: Alicia N. M. Kraay, University of Illinois; Molly E. Gallagher, Johns Hopkins University; Yang Ge, University of Southern Mississippi; Peichun Han, Emory University; Julia M. Baker, Centers for Disease Control and Prevention; Katharina V. Koelle, Emory University; Andreas Handel, Emory University; Ben Lopman, Emory University
• Language: English
• Date: 2021-03-13
• Publisher: Cold Spring Harbor Laboratory
• Publication Version: Preprint (Prior to Peer Review)
• Copyright Statement: The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1101/2021.03.12.21253481
• Title of Journal or Parent Work: medRxiv
• Grant/Funding Information: ANMK, MEG, PH, YG, KK, BAL, and KK were supported by NIH/NIGMS (R01 GM 12480-03S1). ANMK and BAL were supported by NSF (2032084). JMB was supported by Award Number T32AI074492 from NIAID.
• Keywords: COVID-19 pandemic; vaccines; transmission mode; safety; non-pharmaceutical interventions (NPIs); policies
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Immunology

Abstract

In response to the COVID-19 pandemic, widespread non-pharmaceutical interventions (NPIs), including physical distancing, mask wearing, and enhanced hygiene, have been implemented. As of March 2021, three effective vaccines have been approved for emergency use in the United States, with several other vaccines in the pipeline. We use a transmission model to study when and how NPIs could be relaxed in the United States with relative safety as vaccination becomes more widespread. We compare different relaxation scenarios where NPIs begin to relax 0-9 months after vaccination begins for both a one dose and two dose strategy, with historical levels of social interactions being reached within 1 month to 1 year. In our model, vaccination can allow widespread relaxation of NPIs to begin safely within 2 to 9 months, greatly reducing deaths and peak health system burden compared to relaxing NPIs without vaccination. Vaccinated individuals can safely begin to relax NPIs sooner than unvaccinated individuals. The extent of delay needed to safely reopen depends primarily on the rate of vaccine rollout, with the degree of protection against asymptomatic infection playing a secondary role. If a vaccination rate of 3 million doses/day can be achieved, similar to the typical rollout speed of seasonal influenza vaccination, NPIs could begin to be safely relaxed in 2-3 months. With a vaccination rate of 1 million doses/day, a 6–9-month delay is needed. A one dose strategy is preferred if relative efficacy is similar to a two-dose series, but the relative benefit of this strategy is minimal when vaccine rollout is fast. Due to the urgent need to pursue strategies that enable safe relaxation of NPIs, we recommend a two-dose strategy with an initial delay of at least 3 months in relaxing restrictions further, and that the speed of vaccine rollout be given immediate priority.