Waiting for the Perfect Vaccine

Vaccination has proven to be the most effective public health measure in the fight against various infectious diseases. For emerging or re-emerging diseases, a highly efficacious vaccine may not be available at the start of an outbreak. Timelines for availability of a safe and effective vaccine may significantly affect disease dynamics, its burden, and the healthcare resource utilization. Mitigating this impact may then rely on low-efficacy vaccines that may be rapidly produced and distributed to at-risk populations at the early stages of an outbreak. With the expectation for arrival of a more effective vaccine at a later stage of the outbreak, the optimal vaccination coverage with the existing, low-efficacy vaccines is elusive. While flattening the outbreak if a significant proportion of the susceptible population is vaccinated with a low-efficacy vaccine, the overall infections may not be minimized if a small proportion of the population left unvaccinated when a highly efficacious vaccine becomes available. The optimal coverage for early vaccination could thus depend on several parameters including the efficacy of the currently available vaccines, arrival timing of a more effective vaccine and its efficacy, and the transmissbility of the disease. Here, we develop a deterministic system of differential equations to investigate the optimal vaccination coverage with a low-efficacy vaccine within the aforementioned parameter space. Despite simplifying assumptions, we illustrate that minimizing the overall infections does not necessarily correspond to the highest coverage of early vaccination. However, a high vaccination coverage, even with a low-efficacy vaccine, may still contribute to alleviating severe disease outcomes and reducing healthcare resource utilization.