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Multinational epidemics of emerging infectious diseases are increasingly common, due to anthropogenic pressure on ecosystems and the growing connectivity of human populations. Early and efficient vaccination can contain outbreaks and prevent mass mortality, but optimal vaccine stockpiling strategies are dependent on pathogen characteristics, reservoir ecology, and epidemic dynamics. Here, we model major regional outbreaks of Nipah virus and Middle East respiratory syndrome, and use these to develop a generalized framework for estimating vaccine stockpile needs based on spillover geography, spatially-heterogeneous healthcare capacity and spatially-distributed human mobility networks. Because outbreak sizes were highly skewed, we found that most outbreaks were readily contained (median stockpile estimate for MERS-CoV: 2,089 doses; Nipah: 1,882 doses), but the maximum estimated stockpile need in a highly unlikely large outbreak scenario was 2–3 orders of magnitude higher (MERS-CoV: ~87,000 doses; Nipah ~ 1.1 million doses). Sensitivity analysis revealed that stockpile needs were more dependent on basic epidemiological parameters (i.e., death and recovery rate) and healthcare availability than any uncertainty related to vaccine efficacy or deployment strategy. Our results highlight the value of descriptive epidemiology for real-world modeling applications, and suggest that stockpile allocation should consider ecological, epidemiological, and social dimensions of risk.
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Vaccine stockpile sharing for selfish objectives
The COVAX program aims to provide global equitable access to life-saving vaccines. Despite calls for increased sharing, vaccine protectionism has limited progress towards vaccine sharing goals. For example, as of April 2022 only ~20% of the population in Africa had received at least one COVID-19 vaccine dose. Here we use a two-nation coupled epidemic model to evaluate optimal vaccine-sharing policies given a selfish objective: in which countries with vaccine stockpiles aim to minimize fatalities in their own population. Computational analysis of a suite of simulated epidemics reveal that it is often optimal for a donor country to share a significant fraction of its vaccine stockpile with a recipient country that has no vaccine stockpile. Sharing a vaccine stockpile reduces the intensity of outbreaks in the recipient, in turn reducing travel-associated incidence in the donor. This effect is intensified as vaccination rates in a donor country decrease and epidemic coupling between countries increases. Critically, vaccine sharing by a donor significantly reduces transmission and fatalities in the recipient. Moreover, the same computational framework reveals the potential use of hybrid sharing policies that have a negligible effect on fatalities in the donor compared to the optimal policy while significantly reducing fatalities in the recipient. Altogether, these findings provide a self-interested rationale for countries to consider sharing part of their vaccine stockpiles.
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- Award ID(s):
- 1806833
- PAR ID:
- 10461031
- Editor(s):
- Mutheneni, Srinivasa Rao
- Date Published:
- Journal Name:
- PLOS Global Public Health
- Volume:
- 2
- Issue:
- 12
- ISSN:
- 2767-3375
- Page Range / eLocation ID:
- e0001312
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1371/journal.pgph.0001312
