Optimal vaccine allocation for COVID-19 in the Netherlands: a data-driven prioritization

Abstract For the control of COVID-19, vaccination programmes provide a long-term solution. The amount of available vaccines is often limited, and thus it is crucial to determine the allocation strategy. While mathematical modelling approaches have been used to find an optimal distribution of vaccines, there is an excessively large number of possible schemes to be simulated. Here, we propose an algorithm to find a near-optimal allocation scheme given an intervention objective such as minimization of new infections, hospitalizations, or deaths, where multiple vaccines are available. The proposed principle for allocating vaccines is to target subgroups with the largest reduction in the outcome of interest, such as new infections, due to vaccination that fully immunizes a single individual. We express the expected impact of vaccinating each subgroup in terms of the observed incidence of infection and force of infection. The proposed approach is firstly evaluated with a simulated epidemic and then applied to the epidemiological data on COVID-19 in the Netherlands. Our results reveal how the optimal allocation depends on the objective of infection control. In the case of COVID-19, if we wish to minimize deaths, the optimal allocation strategy is not efficient for minimizing other outcomes, such as infections. In simulated epidemics, an allocation strategy optimized for an outcome outperforms other strategies such as the allocation from young to old, from old to young, and at random. Our simulations clarify that the current policy in the Netherlands (i.e., allocation from old to young) was concordant with the allocation scheme that minimizes deaths. The proposed method provides an optimal allocation scheme, given routine surveillance data that reflect ongoing transmissions. The principle of allocation is useful for providing plausible simulation scenarios for complex models, which give a more robust basis to determine intervention strategies. Author summary Vaccination is the key to controlling the ongoing COVID-19 pandemic. In the early stages of an epidemic, there is shortage of vaccine stocks. Here, we propose an algorithm that computes an optimal vaccine distribution among groups for each intervention objective (e.g., minimizing new infections, hospitalizations, or deaths). Unlike existing approaches that use detailed information on at-risk contacts between and among groups, the proposed algorithm requires only routine surveillance data on the number of cases. This method is applicable even when multiple vaccines are available. Simulation results show that the allocation scheme optimized by our algorithm performed the best compared with other strategies such as allocating vaccines at random and in the order of age. Our results also reveal that an allocation scheme optimized for one specific objective is not necessarily efficient for another, indicating the importance of the decision-making at the early phase of distributions.