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Potential impact of annual vaccination with reformulated COVID-19 vaccines: Lessons from the US COVID-19 scenario
Sung-Mok Jung1, Sara L Loo2, Emily Howerton3
1University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Insights
COVID-19 will remain a significant threat, causing millions of hospitalizations and hundreds of thousands of deaths over the next two years. Annual vaccination, especially for all eligible individuals, can substantially reduce these severe outcomes and save lives.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Modeling
Background:
- Coronavirus Disease 2019 (COVID-19) continues to pose a substantial public health challenge in the United States, with ongoing hospitalizations and fatalities.
- The long-term impact of COVID-19 and the effectiveness of annually updated vaccines require further investigation.
Purpose of the Study:
- To project COVID-19 hospitalizations and deaths in the U.S. for the next two years.
- To evaluate the impact of varying levels of viral immune escape (20% and 50% annually).
- To assess the effect of different Centers for Disease Control and Prevention (CDC) vaccine recommendations on disease burden.
Main Methods:
- Utilized the COVID-19 Scenario Modeling Hub to solicit and ensemble projections from eight modeling teams.
- Simulated scenarios based on annual immune escape rates and three vaccine uptake strategies (no recommendation, 65+ vaccination, all-age vaccination).
- Assumed reformulated vaccines are 65% effective and available annually, with coverage matching the 2021 booster campaign.
Main Results:
- Projected annual COVID-19 epidemics peaking from November to January between April 2023 and April 2025.
- In a high immune escape scenario with no vaccination, an estimated 2.1 million hospitalizations and 209,000 deaths are predicted.
- Broad vaccination (all eligible) could prevent approximately 431,000 hospitalizations and 49,000 deaths annually in high immune escape scenarios.
Conclusions:
- COVID-19 is expected to remain a significant public health concern for the next two years.
- Widespread vaccination campaigns hold considerable potential to mitigate disease severity and reduce mortality.
- Targeted vaccination, particularly for older adults and all eligible populations, can lead to substantial reductions in hospitalizations and deaths.
Background:
Coronavirus Disease 2019 (COVID-19) continues to cause significant hospitalizations and deaths in the United States. Its continued burden and the impact of annually reformulated vaccines remain unclear. Here, we present projections of COVID-19 hospitalizations and deaths in the United States for the next 2 years under 2 plausible assumptions about immune escape (20% per year and 50% per year) and 3 possible CDC recommendations for the use of annually reformulated vaccines (no recommendation, vaccination for those aged 65 years and over, vaccination for all eligible age groups based on FDA approval).
Methods And Findings:
The COVID-19 Scenario Modeling Hub solicited projections of COVID-19 hospitalization and deaths between April 15, 2023 and April 15, 2025 under 6 scenarios representing the intersection of considered levels of immune escape and vaccination. Annually reformulated vaccines are assumed to be 65% effective against symptomatic infection with strains circulating on June 15 of each year and to become available on September 1. Age- and state-specific coverage in recommended groups was assumed to match that seen for the first (fall 2021) COVID-19 booster. State and national projections from 8 modeling teams were ensembled to produce projections for each scenario and expected reductions in disease outcomes due to vaccination over the projection period. From April 15, 2023 to April 15, 2025, COVID-19 is projected to cause annual epidemics peaking November to January. In the most pessimistic scenario (high immune escape, no vaccination recommendation), we project 2.1 million (90% projection interval (PI) [1,438,000, 4,270,000]) hospitalizations and 209,000 (90% PI [139,000, 461,000]) deaths, exceeding pre-pandemic mortality of influenza and pneumonia. In high immune escape scenarios, vaccination of those aged 65+ results in 230,000 (95% confidence interval (CI) [104,000, 355,000]) fewer hospitalizations and 33,000 (95% CI [12,000, 54,000]) fewer deaths, while vaccination of all eligible individuals results in 431,000 (95% CI: 264,000-598,000) fewer hospitalizations and 49,000 (95% CI [29,000, 69,000]) fewer deaths.
Conclusions:
COVID-19 is projected to be a significant public health threat over the coming 2 years. Broad vaccination has the potential to substantially reduce the burden of this disease, saving tens of thousands of lives each year.
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