A quantitative evaluation of the impact of vaccine roll-out rate and coverage on reducing deaths: insights from the first 2 years of COVID-19 epidemic in Iran
Ghafari, Mahan, Hosseinpour, Sepanta, Rezaee-Zavareh Mohammad Saeid, Dascalu, Stefan, Rostamian, Somayeh, Aramesh, Kiarash, Madani, Kaveh and Kordasti, Shahram, (2023). A quantitative evaluation of the impact of vaccine roll-out rate and coverage on reducing deaths: insights from the first 2 years of COVID-19 epidemic in Iran. BMC Medicine, 21 429
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http://dx.doi.org/10.1186/s12916-023-03127-8 Full text from publisher -
Sub-type Journal article Author Ghafari, Mahan
Hosseinpour, Sepanta
Rezaee-Zavareh Mohammad Saeid
Dascalu, Stefan
Rostamian, Somayeh
Aramesh, Kiarash
Madani, Kaveh
Kordasti, ShahramTitle A quantitative evaluation of the impact of vaccine roll-out rate and coverage on reducing deaths: insights from the first 2 years of COVID-19 epidemic in Iran Appearing in BMC Medicine Volume 21 Publication Date 2023-11-13 Place of Publication Berlin Publisher Springer Nature Start page 429 Language eng Abstract Background Vaccination has played a pivotal role in reducing the burden of COVID-19. Despite numerous studies highlighting its benefits in reducing the risk of severe disease and death, we still lack a quantitative understanding of how varying vaccination roll-out rates influence COVID-19 mortality. Methods We developed a framework for estimating the number of avertable COVID-19 deaths (ACDs) by vaccination in Iran. To achieve this, we compared Iran’s vaccination roll-out rates with those of eight model countries that predominantly used inactivated virus vaccines. We calculated net differences in the number of fully vaccinated individuals under counterfactual scenarios where Iran’s per-capita roll-out rate was replaced with that of the model countries. This, in turn, enabled us to determine age specific ACDs for the Iranian population under counterfactual scenarios where number of COVID-19 deaths are estimated using all-cause mortality data. These estimates covered the period from the start of 2020 to 20 April 2022. Results We found that while Iran would have had an approximately similar number of fully vaccinated individuals under counterfactual roll-out rates based on Bangladesh, Nepal, Sri Lanka, and Turkey (~ 65–70%), adopting Turkey’s roll-out rates could have averted 50,000 (95% confidence interval: 38,100–53,500) additional deaths, while following Bangladesh’s rates may have resulted in 52,800 (17,400–189,500) more fatalities in Iran. Surprisingly, mimicking Argentina’s slower roll-out led to only 12,600 (10,400–13,300) fewer deaths, despite a higher counterfactual percentage of fully vaccinated individuals (~ 79%). Emulating Montenegro or Bolivia, with faster per capita roll-out rates and approximately 50% counterfactual full vaccination, could have prevented more deaths in older age groups, especially during the early waves. Finally, replicating Bahrain’s model as an upper-bound benchmark, Iran could have averted 75,300 (56,000–83,000) deaths, primarily in the > 50 age groups. Conclusions Our analysis revealed that faster roll-outs were consistently associated with higher numbers of averted deaths, even in scenarios with lower overall coverage. This study offers valuable insights into future decision-making regarding infectious disease epidemic management through vaccination strategies. It accomplishes this by comparing various countries’ relative performance in terms of timing, pace, and vaccination coverage, ultimately contributing to the prevention of COVID-19-related deaths. Keyword COVID-19
Vaccination
Excess mortality
Counterfactual scenarios
Decision-makingCopyright Holder author(s) Copyright Year 2023 Copyright type Creative commons ISSN 1741-7015 DOI 10.1186/s12916-023-03127-8 -
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