This prioritization relies on the evidence that COVID-19 patients with pre-existing health conditions, including diabetes and hypertension, are 2–4 times more likely to develop severe disease than those without comorbidities.
We explored a strategy where healthcare workers and high-risk individuals, including those with comorbidities associated with severe COVID-19 and individuals aged 65 and older, were prioritized for vaccination. To project the impact of vaccination and roll-out during ongoing outbreaks, we developed an age-structured transmission model, taking into account comorbidities and demographics of the US population. Implementation of vaccination programs will likely take several months, depending on the ability to roll out clinics and security of vaccine supply in each state. This compels an urgent need to understand the potential population-level impact of vaccination on COVID-19 transmission and disease outcomes. These vaccines have received emergency use authorization by the FDA, and vaccination has already started in the US with prioritization of healthcare workers, long-term care residents, and high-risk individuals. Results from two large efficacy trials (Pfizer - BioNTech, Moderna) indicate a vaccine efficacy of over 90% against symptomatic and severe disease, exceeding the preferred population-based efficacy specified by the World Health Organization and the United States (US) Food and Drug Administration (FDA). As of December 31, 2020, safety and efficacy results for a number of vaccines have been reported, and Phase III clinical trials for several other candidates are underway. To mitigate the mounting burden of COVID-19, vaccine development has occurred at an unprecedented pace. However, the vast majority of the global population remains susceptible to COVID-19, highlighting the need for an effective vaccine. Despite unprecedented movement restrictions, social distancing measures, and stay-at-home orders enacted in many countries, the COVID-19 pandemic has caused devastating morbidity and mortality.
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