scholarly journals Evaluation of COVID-19 vaccination strategies with a delayed second dose

PLoS Biology ◽  
2021 ◽  
Vol 19 (4) ◽  
pp. e3001211
Author(s):  
Seyed M. Moghadas ◽  
Thomas N. Vilches ◽  
Kevin Zhang ◽  
Shokoofeh Nourbakhsh ◽  
Pratha Sah ◽  
...  
Keyword(s):  
Program Effectiveness ◽  
Credible Interval ◽  
The United States ◽  
Optimal Time ◽  
Time Interval ◽  
Policy Debate ◽  
Agent Based ◽  
Vaccination Strategies ◽  
Supply And Distribution ◽  
The Impact

Two of the Coronavirus Disease 2019 (COVID-19) vaccines currently approved in the United States require 2 doses, administered 3 to 4 weeks apart. Constraints in vaccine supply and distribution capacity, together with a deadly wave of COVID-19 from November 2020 to January 2021 and the emergence of highly contagious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants, sparked a policy debate on whether to vaccinate more individuals with the first dose of available vaccines and delay the second dose or to continue with the recommended 2-dose series as tested in clinical trials. We developed an agent-based model of COVID-19 transmission to compare the impact of these 2 vaccination strategies, while varying the temporal waning of vaccine efficacy following the first dose and the level of preexisting immunity in the population. Our results show that for Moderna vaccines, a delay of at least 9 weeks could maximize vaccination program effectiveness and avert at least an additional 17.3 (95% credible interval [CrI]: 7.8–29.7) infections, 0.69 (95% CrI: 0.52–0.97) hospitalizations, and 0.34 (95% CrI: 0.25–0.44) deaths per 10,000 population compared to the recommended 4-week interval between the 2 doses. Pfizer-BioNTech vaccines also averted an additional 0.60 (95% CrI: 0.37–0.89) hospitalizations and 0.32 (95% CrI: 0.23–0.45) deaths per 10,000 population in a 9-week delayed second dose (DSD) strategy compared to the 3-week recommended schedule between doses. However, there was no clear advantage of delaying the second dose with Pfizer-BioNTech vaccines in reducing infections, unless the efficacy of the first dose did not wane over time. Our findings underscore the importance of quantifying the characteristics and durability of vaccine-induced protection after the first dose in order to determine the optimal time interval between the 2 doses.

scholarly journals Evaluation of COVID-19 vaccination strategies with a delayed second dose

2021 ◽  
Author(s):  
Seyed M. Moghadas ◽  
Thomas N. Vilches ◽  
Kevin Zhang ◽  
Shokoofeh Nourbakhsh ◽  
Pratha Sah ◽  
...  
Keyword(s):  
Vaccine Efficacy ◽  
Program Effectiveness ◽  
The United States ◽  
Optimal Time ◽  
Time Interval ◽  
Policy Debate ◽  
Agent Based ◽  
Vaccination Strategies ◽  
Supply And Distribution ◽  
The Impact

AbstractCOVID-19 vaccines currently approved in the United States require two doses, administered three to four weeks apart. Constraints in vaccine supply and distribution capacity, together with the rise of COVID-19 cases and hospitalizations, have sparked a policy debate on whether to vaccinate more individuals with the first dose of available vaccines and delay the second dose, or to continue with the recommended two-dose series as tested in clinical trials. We developed an agent-based model of COVID-19 transmission to compare the impact of these two vaccination strategies, while varying the temporal waning of vaccine efficacy against disease following the first dose, vaccine efficacy against infection, and the level of pre-existing immunity in the population. Our results show that for Moderna vaccines with 80% efficacy following the first dose, a delay of 9-12 weeks could enhance the program effectiveness and prevent additional infections, hospitalizations, and deaths, compared to a 4-week interval between the doses. However, for Pfizer-BioNTech vaccines with demonstrated efficacy of 52% after the first dose, there was no clear advantage for delaying the second dose beyond the 3-week tested schedule, unless the efficacy of the first dose did not wane over time. Our findings underscore the importance of quantifying the durability of vaccine-induced protection after the first dose as well as vaccine efficacy against infection in order to determine the optimal time interval between the two doses.

scholarly journals Modeling the impact of vaccination strategies for nursing homes in the context of increased SARS-CoV-2 community transmission and variants

2021 ◽  
Author(s):  
Inga Holmdahl ◽  
Rebecca Kahn ◽  
Kara Jacobs Slifka ◽  
Kathleen Dooling ◽  
Rachel B Slayton
Keyword(s):  
Nursing Homes ◽  
Vaccination Coverage ◽  
The United States ◽  
Agent Based ◽  
Booster Vaccine ◽  
Vaccination Strategies ◽  
Primary Series ◽  
Community Transmission ◽  
The Impact ◽  
To Receive

Nursing homes (NH) were among the first settings to receive COVID-19 vaccines in the United States, but staff vaccination coverage remains low at an average of 64%. Using an agent-based model, we examined the impact of community prevalence, the Delta variant, staff vaccination coverage, and boosters for residents on outbreak dynamics in nursing homes. We found that increased staff primary series coverage and high booster vaccine effectiveness (VE) in residents leads to fewer infections and that the cumulative incidence is highly dependent on community transmission. Despite high VE, high community transmission resulted in continued symptomatic infections in NHs.

The impact of the workability of an automated technological system on the effective implementation of the production program when processing tools in glow discharge plasma generators

2021 ◽  
pp. 58-65
Author(s):  
V.A. Logvin ◽  
◽  
S.A. Sheptunov ◽  
Keyword(s):  
Glow Discharge ◽  
Discharge Plasma ◽  
Functional Dependence ◽  
Plasma Generator ◽  
Glow Discharge Plasma ◽  
Optimal Time ◽  
Time Interval ◽  
Production Program ◽  
The Impact ◽  
Plasma Generators

The conditions for the hardening of tools in accordance with the author’s technological routes in the optimal time interval are considered using the functional dependence of the serviceability of plasma generators. This dependence takes into account the workability of the technical devices involved in processing the laying batch of tools in the speci ed time interval. The probability of performing the production process in the estimated time is represented by the product of the trouble-free operation of each glow discharge plasma generator involved in the nishing processing of tools that require a different type of plasma exposure in a certain sequence and duration.

The 2016 U.S. Presidential Campaign: Changing Discourse on Palestine

2016 ◽  
Vol 46 (1) ◽  
pp. 34-49
Author(s):  
Phyllis Bennis
Keyword(s):  
United States ◽  
Democratic Party ◽  
The United States ◽  
Presidential Campaign ◽  
Antiwar Movement ◽  
Policy Debate ◽  
Policy Analyst ◽  
Long Time ◽  
The Impact

This essay examines the discourse on Palestine/Israel in the 2016 U.S. presidential campaign, charting the impact of the Palestine rights movement on the domestic U.S. policy debate. Policy analyst, author, and long-time activist Phyllis Bennis notes the sea change within the Democratic Party evident in the unprecedented debate on the issue outside traditionally liberal Zionist boundaries. The final Democratic platform was as pro-Israel and anti-Palestinian as any in history, but the process of getting there was revolutionary in no small part, Bennis argues, due to the grassroots campaign of veteran U.S. senator Bernie Sanders. Bennis also discusses the Republican platform on Israel/Palestine, outlining the positions of the final three Republican contenders. Although she is clear about the current weakness of the broad antiwar movement in the United States, Bennis celebrates its Palestinian rights component and its focus on education and BDS to challenge the general public's “ignorance” on Israel/Palestine.

scholarly journals Assessing the Impact of Lifestyle Interventions on Diabetes Prevention in China: A Modeling Approach

2019 ◽  
Vol 16 (10) ◽  
pp. 1677 ◽  
Author(s):  
Linna Luo ◽  
Bowen Pang ◽  
Jian Chen ◽  
Yan Li ◽  
Xiaolei Xie
Keyword(s):  
Physical Activity ◽  
Peer Influence ◽  
Diabetes Prevention ◽  
The United States ◽  
Population Based ◽  
Agent Based ◽  
Individual Health ◽  
Time Period ◽  
Lower Body Weight ◽  
The Impact

China’s diabetes epidemic is getting worse. People with diabetes in China usually have a lower body weight and a different lifestyle profile compared to their counterparts in the United States (US). More and more evidence show that certain lifestyles can possibly be spread from person to person, leading some to propose considering social influence when establishing preventive policies. This study developed an innovative agent-based model of the diabetes epidemic for the Chinese population. Based on the risk factors and related complications of diabetes, the model captured individual health progression, quantitatively described the peer influence of certain lifestyles, and projected population health outcomes over a specific time period. We simulated several hypothetical interventions (i.e., improving diet, controlling smoking, improving physical activity) and assessed their impact on diabetes rates. We validated the model by comparing simulation results with external datasets. Our results showed that improving physical activity could result in the most significant decrease in diabetes prevalence compared to improving diet and controlling smoking. Our model can be used to inform policymakers on how the diabetes epidemic develops and help them compare different diabetes prevention programs in practice.

scholarly journals The Impact of Vaccination to Control COVID-19 Burden in the United States: A Simulation Modeling Approach

2021 ◽  
Author(s):  
Oguzhan Alagoz ◽  
Ajay K. Sethi ◽  
Brian W. Patterson ◽  
Matthew Churpek ◽  
Ghalib Alhanaee ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Simulation Modeling ◽  
Vaccine Coverage ◽  
The United States ◽  
Funding Source ◽  
Vaccination Programs ◽  
Agent Based ◽  
Nonpharmaceutical Interventions ◽  
The Impact

ABSTRACTIntroductionVaccination programs aim to control the COVID-19 pandemic. However, the relative impacts of vaccine coverage, effectiveness, and capacity in the context of nonpharmaceutical interventions such as mask use and physical distancing on the spread of SARS-CoV-2 are unclear. Our objective was to examine the impact of vaccination on the control of SARS-CoV-2 using our previously developed agent-based simulation model.MethodsWe applied our agent-based model to replicate COVID-19-related events in 1) Dane County, Wisconsin; 2) Milwaukee metropolitan area, Wisconsin; 3) New York City (NYC). We evaluated the impact of vaccination considering the proportion of the population vaccinated, probability that a vaccinated individual gains immunity, vaccination capacity, and adherence to nonpharmaceutical interventions. The primary outcomes were the number of confirmed COVID-19 cases and the timing of pandemic control, defined as the date after which only a small number of new cases occur. We also estimated the number of cases without vaccination.ResultsThe timing of pandemic control depends highly on vaccination coverage, effectiveness, and adherence to nonpharmaceutical interventions. In Dane County and Milwaukee, if 50% of the population is vaccinated with a daily vaccination capacity of 0.1% of the population, vaccine effectiveness of 90%, and the adherence to nonpharmaceutical interventions is 65%, controlled spread could be achieved by July 2021 and August 2021, respectively versus in March 2022 in both regions without vaccine. If adherence to nonpharmaceutical interventions increases to 70%, controlled spread could be achieved by May 2021 and April 2021 in Dane County and Milwaukee, respectively.DiscussionIn controlling the spread of SARS-CoV-2, the impact of vaccination varies widely depending not only on effectiveness and coverage, but also concurrent adherence to nonpharmaceutical interventions. The effect of SARS-CoV-2 variants was not considered.Primary Funding SourceNational Institute of Allergy and Infectious Diseases

scholarly journals The Impact of NAFTA on the United States

2001 ◽  
Vol 15 (1) ◽  
pp. 125-144 ◽  
Author(s):  
Mary E Burfisher ◽  
Sherman Robinson ◽  
Karen Thierfelder
Keyword(s):  
Free Trade Agreement ◽  
Trade Agreement ◽  
Trade Diversion ◽  
The United States ◽  
Trade Creation ◽  
Policy Debate ◽  
Trade Data ◽  
The North ◽  
The Impact ◽  
The U.S

We describe the main economic arguments posed for and against the North American Free Trade Agreement (NAFTA) during the U.S. policy debate. To evaluate these arguments, we analyze recent trade data and survey post-NAFTA studies. We find that both the U.S. and Mexico benefit from NAFTA, with much larger relative benefits for Mexico. NAFTA also has had little effect on the U.S. labor market. These results confirm the consensus opinion of economists at the time of the debate. Finally, studies find that trade creation greatly exceeds trade diversion in the region under NAFTA, especially in intermediate goods.

scholarly journals The Daily Resistive Index measurement useful tool in the estimation of the optimal time interval between two Shock Wave Lithotripsy sessions.

2015 ◽  
Vol 17 (2) ◽  
pp. 175
Author(s):  
Esin Yencilek ◽  
Aysegul Sarsılmaz ◽  
Ozgur Kilickesmez ◽  
Hakan Koyuncu ◽  
Bilal Eryildirim ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Wave Lithotripsy ◽  
Resistive Index ◽  
Optimal Time ◽  
Time Interval ◽  
Index Measurement ◽  
The Mean ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Aims: To monitor the impact of Shock Wave Lithotripsy (SWL) on the renal resisive index (RI) and to investigate the potential of the RI measurement for the estimation of the optimal duration between 2 SWL sessions. Material and methods: Thirty patients with single pelvis renalis stone were included. Participitants were grouped according to their age as group 1 (<40 years, mean age 36.2±3.9 years) and group 2 (≥40 years, mean age 55.4±6.5 years). RI measurement was performed in of all patients prior to SWL. After SWL, RI was monitored daily until RI returned to their pre-SWL values. Results: The mean stone size was 2 8.97±3.62 in group 1 and 10.08±4.67 mm in group 2 (p=0.077). Following SWL, the  RI value of both goups increased and the higher RI value was measured at the 24th hour as compared with their pre-SWL values (p<0.001). In day 2 RI of the groups declined, but the differences were still statistically different from their pre-SWL RI values (p<0.001). However, on the third day, RI of group 1 was close to their pre-SWL level (p=0.143). But, in group 2, RI value returned to their pre-SWL limits on day 4 (p=0.229). Conclusions: RI measurement gives important data regarding SWL related acute renal trauma and should be used as an US marker for recovery after SWL. 

scholarly journals Impact of non-pharmaceutical interventions on documented cases of COVID-19

2020 ◽  
Author(s):  
Nicolas Banholzer ◽  
Eva van Weenen ◽  
Bernhard Kratzwald ◽  
Arne Seeliger ◽  
Daniel Tschernutter ◽  
...  
Keyword(s):  
Credible Interval ◽  
The United States ◽  
Current Control ◽  
Relative Reduction ◽  
Control Mechanisms ◽  
Global Epidemic ◽  
Country Analysis ◽  
Cross Country ◽  
The Impact ◽  
Pharmaceutical Interventions

AbstractBackgroundThe novel coronavirus (SARS-CoV-2) has rapidly evolved into a global epidemic. To control its spread, countries have implemented non-pharmaceutical interventions (NPIs), such as school or border closures, while others have even enforced complete lockdowns. Here we study the impact of NPIs in reducing documented cases of COVID-19. Documented case numbers are selected because they are essential for decision-makers in the area of health-policy when monitoring and evaluating current control mechanisms.MethodsWe empirically estimate the relative reduction in the number of new cases attributed to each NPI. A cross-country analysis is performed using documented cases through April 15, 2020 from n = 20 countries (i.e., the United States, Canada, Australia, the EU-15 countries, Norway, and Switzerland).ResultsAs of April 15, venue closures were associated with a reduction in the number of new cases by 36 % (95% credible interval [CrI] 20–48 %), closely followed by gathering bans (34 %; 95% CrI 21–45 %), border closures (31 %; 95% CrI 19–42 %), and work bans on non-essential business activities (31 %; 95% CrI 16–44 %). Event bans lead to a slightly less pronounced reduction (23 %; 95% CrI 8–35 %). School closures (8 %; 95% CrI 0–23 %) and lockdowns (5 %; 95% CrI 0–14 %) appeared to be the least effective among the NPIs considered in this analysis.ConclusionsWith this cross-country analysis, we provide early estimates regarding the impact of different NPIs for controlling the COVID-19 epidemic. These findings are relevant for evaluating current health-policies.

scholarly journals Evaluating a Geriatric Educational Program: Exploring Opportunities for Increasing Impact and Scale

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 758-758
Author(s):  
Shera Hosseini ◽  
Michelle Howard ◽  
Allison Ward
Keyword(s):  
Large Scale ◽  
Healthcare Professionals ◽  
Program Effectiveness ◽  
Qualitative Interviews ◽  
A Priori ◽  
The United States ◽  
Dissemination And Implementation ◽  
Geriatric Population ◽  
Learning Competencies ◽  
The Impact

Abstract The geriatric population is rapidly growing, and this growth is beyond the pace of increase in the number of healthcare professionals who are qualified to care for and tend to the various needs of this significant subgroup of the population. The current university curricula have not been sufficient in terms of quantity as well as their ability to address the ageism inherent in the perspectives of students from across the educational spectrum. In recognition of the absence of standardized geriatric guidelines, medical associations across Canada and the United States have established geriatric learning competencies for medical programs. Nevertheless, there are exiting gaps regarding the development and evaluation of geriatric-focused didactic programs that adequately train and build competency among the students interested in pursuing careers with geriatric-specific elements. A university-wide program was developed to enhance aging education and build competency through sparking interest, providing better education related to aging, and building better relationships between future healthcare professionals and older adults. To evaluate the impact of this program, a logical framework was developed a-priori and revised through constant iterations and following discussion with the program’s multidisciplinary stakeholder group. Quantitative measures are being augmented with in-depth qualitative interviews to explore elements influencing students’ experiences with the program and the effect on their interests in and attitudes towards geriatrics. The results will inform our conclusions regarding program effectiveness in enhancing interest in geriatric-focused education among the students and trainees and assist with recommending future directions regarding impact and large-scale dissemination and implementation.

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