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Researchers say the U.S. COVID-19 vaccine program worked well, but there are still lessons to be learned. Janice Chen/Getty Images
  • 在一项新研究中，研究人员分析了CDC在大流行期间使用的COVID-19疫苗计划的工作状况。
  • They concluded the programs came close to the “optimal” outcomes that were mathematically calculated.
  • 他们说，不过，在确定目标和分发疫苗时，仍然需要学习教训。
  • 研究人员说，其中一个目标应该是所有社区接种疫苗的平等通道。

Now that COVID-19 vaccines — and boosters — have been offered to all people in the United States, a 新研究 examines how the initial vaccine rollout performed against mathematical models that have the benefit of hindsight.

研究人员说，他们发现美国的方法不是完美的，但是做得很好。

When the Centers for Disease Control and Prevention (CDC) began its COVID-19 vaccine rollout, it prioritized people by age, jobs (frontline medical workers and others got priority), and comorbidities that made COVID-19 more severe, among other factors.

The researchers from Iowa State University then took those characteristics in the CDC’s rollout recommendations and sorted them into 17 subpopulations.

这导致了超过170亿次可以分配疫苗和1700万个分配策略，这些策略可以被视为“最佳”。

总而言之，疾病预防控制中心的方法估计增加了0.19％的死亡，相对于19例COVID 19例，感染增加了4％，损失了4％，比数学上最佳模型多少于1％。

And that’s pretty impressive, saidDr. William Lang, MHA, the medical director of WorldClinic and JobSiteCare as well as the former associate chief medical officer of the Department of Homeland Security.

Lang告诉Healthline：“现实生活中的结果与计算出的优化截然不同，这一事实表明了很多专家意见的质量，以敲定我们采用的方法。”雷竞技app官网

“尽管流行病学/数学方法考虑了多个因素，但现实世界中的专家还必须考虑第二阶和三阶效应反应，以包括这种难以夸大的问题，例如另一个社会经济群体的反应，如果另一个社会经济群体的反应是为了获得更高的优先级，各种优先决定对疫苗抵抗的影响，以及有效向一个或另一个目标群体销售疫苗接种的相对能力。”他说。

The question, then, is less about what the CDC got right or wrong, but a more nuanced set of questions around what we prioritize when we are trying to limit harm in the population.

研究作者写道：“任何疫苗的推出都必须平衡几个相互竞争的目标，包括最大程度地减少死亡率和感染，确保人口统计群体的平等以及保持医疗保健能力。”

他们还指出，这些竞争需求之间存在紧张关系。

例如，“在死亡率方面，最公平的分配在所有其他目标中都表现不佳，而最小化总体死亡率的分配导致所有年龄段的死亡人数更加平均，”他们写道。

“That’s important to think about,” said菲尔·史密斯, PhD, MS, a public health expert and an assistant professor of kinesiology, nutrition, and health at Miami University in Ohio.

“目标是否减少了死亡？减少传输？尽快实现牛群免疫？多年的生命失去了？年龄段或其他人口群体的目标公平是目标公平吗？这些问题是要导航的问题。”他说。

“It is also challenging to determine how many vaccines to allocate across states, which may have their own challenges around distribution,” Smith told Healthline.

“Navigating our healthcare payment and reimbursement structure is challenging because it is incredibly complex, but most of that complicated work happens behind the scenes,” he added.

That complex and overstressed healthcare system might be one of our biggest hurdles to “optimizing” our approaches to the next pandemic, including vaccine rollout.

“For many of us in public health, we knew of the gaps, the health disparities, the health inequalities, and the health inequities,” said肯尼斯·坎贝尔（Kenneth L. Campbell）, MPH, the program director of Tulane University’s online Master of Health Administration and an assistant professor in the Tulane School of Public Health and Tropical Medicine in New Orleans.

“我们知道这一点。但是我们不知道是多大that gap would be,” he said. “We didn’t know how those deficiencies would paralyze our ability to reach millions of Americans.”

For instance, despitethe vaccines being free，未保险人接种疫苗，几乎是被保险人的一半，研究显示。

为了产生最佳的结果，我们需要拥有更多强大的结构来始终支持我们的公民。

“医疗保健，教育和育儿不应问。对于这个国家的任何人来说，这应该是绝对的权利。”坎贝尔告诉Healthline。雷竞技app官网“没有这些事情会使家庭在经济上暴露，尤其是已经处于社会劣势的少数民族社区。”

他补充说：“您必须构建系统。”“作为一名前海军陆战队，我们不会等待悲剧发生。我们已经在为这场悲剧进行训练。这就是我们国家必须准备要做的事情。”