• Kate M Bubar, Kyle Reinholt, Stephen M Kissler, Marc Lipsitch, Sarah Cobey, Yonatan H Grad, and Daniel B Larremore.
• Department of Applied Mathematics, University of Colorado Boulder, Boulder, CO 80309, USA. kate.bubar@colorado.edu daniel.larremore@colorado.edu.
• Science. 2021 Feb 26; 371 (6532): 916-921.

AbstractLimited initial supply of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine raises the question of how to prioritize available doses. We used a mathematical model to compare five age-stratified prioritization strategies. A highly effective transmission-blocking vaccine prioritized to adults ages 20 to 49 years minimized cumulative incidence, but mortality and years of life lost were minimized in most scenarios when the vaccine was prioritized to adults greater than 60 years old. Use of individual-level serological tests to redirect doses to seronegative individuals improved the marginal impact of each dose while potentially reducing existing inequities in COVID-19 impact. Although maximum impact prioritization strategies were broadly consistent across countries, transmission rates, vaccination rollout speeds, and estimates of naturally acquired immunity, this framework can be used to compare impacts of prioritization strategies across contexts.Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

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