• Sarah M Bartsch, Kelly J O'Shea, Patrick T Wedlock, Ulrich Strych, Marie C Ferguson, Maria Elena Bottazzi, Samuel L Randall, Sheryl S Siegmund, Sarah N Cox, Peter J Hotez, and Bruce Y Lee.
• Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health & Health Policy, New York City, New York.
• Am J Prev Med. 2021 May 1; 60 (5): 605-613.

IntroductionDuring a pandemic, there are many situations in which the first available vaccines may not have as high effectiveness as vaccines that are still under development or vaccines that are not yet ready for distribution, raising the question of whether it is better to go with what is available now or wait.MethodsIn 2020, the team developed a computational model that represents the U.S. population, COVID-19 coronavirus spread, and vaccines with different possible efficacies (to prevent infection or to reduce severe disease) and vaccination timings to estimate the clinical and economic value of vaccination.ResultsExcept for a limited number of situations, mainly early on in a pandemic and for a vaccine that prevents infection, when an initial vaccine is available, waiting for a vaccine with a higher efficacy results in additional hospitalizations and costs over the course of the pandemic. For example, if a vaccine with a 50% efficacy in preventing infection becomes available when 10% of the population has already been infected, waiting until 40% of the population are infected for a vaccine with 80% efficacy in preventing infection results in 15.6 million additional cases and 1.5 million additional hospitalizations, costing $20.6 billion more in direct medical costs and $12.4 billion more in productivity losses.ConclusionsThis study shows that there are relatively few situations in which it is worth foregoing the first COVID-19 vaccine available in favor of a vaccine that becomes available later on in the pandemic even if the latter vaccine has a substantially higher efficacy.Copyright © 2021. Published by Elsevier Inc.

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