{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T04:12:47Z","timestamp":1783224767271,"version":"3.54.6"},"reference-count":56,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","award":["NIHR200411"],"award-info":[{"award-number":["NIHR200411"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["EP\/S022244\/1"],"award-info":[{"award-number":["EP\/S022244\/1"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Research Council","award":["MR\/V009761\/1"],"award-info":[{"award-number":["MR\/V009761\/1"]}]}],"content-domain":{"domain":["www.ploscompbiol.org"],"crossmark-restriction":false},"short-container-title":["PLoS Comput Biol"],"abstract":"<jats:p>The COVID-19 outbreak has highlighted our vulnerability to novel infections.<\/jats:p>\n                  <jats:p>\n                    Faced with this threat and no effective treatment, in line with many other countries, the UK adopted enforced social distancing (lockdown) to reduce transmission\u2014successfully reducing the reproductive number\n                    <jats:italic>R<\/jats:italic>\n                    below one. However, given the large pool of susceptible individuals that remain, complete relaxation of controls is likely to generate a substantial further outbreak. Vaccination remains the only foreseeable means of both containing the infection and returning to normal interactions and behaviour. Here, we consider the optimal targeting of vaccination within the UK, with the aim of minimising future deaths or quality adjusted life year (QALY) losses. We show that, for a range of assumptions on the action and efficacy of the vaccine, targeting older age groups first is optimal and may be sufficient to stem the epidemic if the vaccine prevents transmission as well as disease.\n                  <\/jats:p>","DOI":"10.1371\/journal.pcbi.1008849","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T13:30:41Z","timestamp":1620307841000},"page":"e1008849","update-policy":"https:\/\/doi.org\/10.1371\/journal.pcbi.corrections_policy","source":"Crossref","is-referenced-by-count":163,"title":["Modelling optimal vaccination strategy for SARS-CoV-2 in the UK"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7786-5342","authenticated-orcid":true,"given":"Sam","family":"Moore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2992-2004","authenticated-orcid":true,"given":"Edward M.","family":"Hill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9788-4858","authenticated-orcid":true,"given":"Louise","family":"Dyson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6875-7232","authenticated-orcid":true,"given":"Michael J.","family":"Tildesley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4639-4765","authenticated-orcid":true,"given":"Matt J.","family":"Keeling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"pcbi.1008849.ref001","unstructured":"Control for Disease Prevention EC. Covid-19 situation update worldwide, as of 16 august 2020. https:\/\/www.ecdc.europa.eu\/en\/geographical-distribution-2019-ncov-cases (accessed August, 2020)."},{"key":"pcbi.1008849.ref002","unstructured":"NHS UK. Check if you or your child has coronavirus symptoms (2020). https:\/\/www.nhs.uk\/conditions\/coronavirus-covid-19\/symptoms\/. [Online] (Accessed: 11 December 2020)."},{"key":"pcbi.1008849.ref003","unstructured":"News B. Coronavirus vaccine: Uk government signs deals for 90 million doses. https:\/\/www.bbc.co.uk\/news\/health-53772650 (accessed August, 2020)."},{"issue":"1","key":"pcbi.1008849.ref004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41541-020-00221-3","article-title":"Evaluation of the immunogenicity of prime-boost vaccination with the replication-deficient viral vectored covid-19 vaccine candidate chadox1 ncov-19","volume":"5","author":"SP Graham","year":"2020","journal-title":"npj Vaccines"},{"key":"pcbi.1008849.ref005","article-title":"Safety and immunogenicity of the chadox1 ncov-19 vaccine against sars-cov-2: a preliminary report of a phase 1\/2, single-blind, randomised controlled trial","author":"PM Folegatti","year":"2020","journal-title":"The Lancet"},{"key":"pcbi.1008849.ref006","article-title":"Ad26-vector based covid-19 vaccine encoding a prefusion stabilized sars-cov-2 spike immunogen induces potent humoral and cellular immune responses","author":"R Bos","year":"2020","journal-title":"bioRxiv"},{"key":"pcbi.1008849.ref007","article-title":"Phase 1\/2 study to describe the safety and immunogenicity of a covid-19 rna vaccine candidate (bnt162b1) in adults 18 to 55 years of age: interim report","author":"MJ Mulligan","year":"2020","journal-title":"medRxiv"},{"key":"pcbi.1008849.ref008","unstructured":"Valneva. Valneva confirms participation in uk government covid-19 vaccine response program. https:\/\/valneva.com\/press-release\/valneva-confirms-participation-in-uk-government-covid-19-vaccine-response-program\/ (accessed August, 2020)."},{"key":"pcbi.1008849.ref009","article-title":"Sars-cov-2 spike glycoprotein vaccine candidate nvx-cov2373 elicits immunogenicity in baboons and protection in mice","author":"JH Tian","year":"2020","journal-title":"bioRxiv"},{"key":"pcbi.1008849.ref010","unstructured":"GlaxoSmithKline. Gsk vaccine press release. https:\/\/www.gsk.com\/en-gb\/media\/press-releases\/sanofi-and-gsk-to-join-forces-in-unprecedented-vaccine-collaboration-to-fight-covid-19\/ (accessed August, 2020)."},{"issue":"937","key":"pcbi.1008849.ref011","article-title":"A snapshot of the global race for vaccines targeting sars-cov-2 and the covid-19 pandemic","volume":"11","author":"CD Funk","year":"2020","journal-title":"Frontiers in Pharmacology"},{"issue":"7809","key":"pcbi.1008849.ref012","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1038\/d41586-020-01092-3","article-title":"Coronavirus vaccine trials have delivered their first results-but their promise is still unclear","volume":"581","author":"E Callaway","year":"2020","journal-title":"Nature"},{"key":"pcbi.1008849.ref013","article-title":"Predictions of covid-19 dynamics in the uk: short-term forecasting and analysis of potential exit strategies","author":"MJ Keeling","year":"2020","journal-title":"medRxiv"},{"key":"pcbi.1008849.ref014","article-title":"Fitting to the UK COVID-19 outbreak, short-term forecasts and estimating the reproductive number","author":"MJ Keeling","year":"2020","journal-title":"medRxiv"},{"key":"pcbi.1008849.ref015","article-title":"Household transmission of SARS-CoV-2 and risk factors for susceptibility and infectivity in Wuhan: a retrospective observational study","author":"F Li","year":"2021","journal-title":"Lancet Infect. Dis"},{"issue":"6","key":"pcbi.1008849.ref016","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.vaccine.2012.12.010","article-title":"Cost-effectiveness of childhood influenza vaccination in england and wales: results from a dynamic transmission model","volume":"31","author":"R Pitman","year":"2013","journal-title":"Vaccine"},{"issue":"1","key":"pcbi.1008849.ref017","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1186\/s12916-015-0452-y","article-title":"Extending the elderly-and risk-group programme of vaccination against seasonal influenza in england and wales: a cost-effectiveness study","volume":"13","author":"M Baguelin","year":"2015","journal-title":"BMC medicine"},{"issue":"1","key":"pcbi.1008849.ref018","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1186\/s12879-019-4108-y","article-title":"Assessing the cost-effectiveness of hpv vaccination strategies for adolescent girls and boys in the uk","volume":"19","author":"S Datta","year":"2019","journal-title":"BMC infectious diseases"},{"issue":"10","key":"pcbi.1008849.ref019","doi-asserted-by":"crossref","first-page":"e1007096","DOI":"10.1371\/journal.pcbi.1007096","article-title":"Seasonal influenza: Modelling approaches to capture immunity propagation","volume":"15","author":"EM Hill","year":"2019","journal-title":"PLoS computational biology"},{"key":"pcbi.1008849.ref020","doi-asserted-by":"crossref","unstructured":"Archer SL. Providing care for the 99.9% during the covid-19 pandemic: How ethics, equity, epidemiology, and cost per qaly inform healthcare policy. In Healthcare management forum, page 0840470420939854. SAGE Publications Sage CA: Los Angeles, CA (2020).","DOI":"10.1177\/0840470420939854"},{"key":"pcbi.1008849.ref021","article-title":"Evidence-based, cost-effective interventions to suppress the covid-19 pandemic: a rapid systematic review","author":"CE Juneau","year":"2020","journal-title":"medRxiv"},{"key":"pcbi.1008849.ref022","article-title":"Vaccine optimization for covid-19, who to vaccinate first?","author":"L Matrajt","year":"2020","journal-title":"medRxiv"},{"key":"pcbi.1008849.ref023","article-title":"Vaccine efficacy needed for a covid-19 coronavirus vaccine to prevent or stop an epidemic as the sole intervention","author":"SM Bartsch","year":"2020","journal-title":"American journal of preventive medicine"},{"key":"pcbi.1008849.ref024","article-title":"Will an imperfect vaccine curtail the covid-19 pandemic in the us?","author":"AB Gumel","year":"2020","journal-title":"medRxiv"},{"issue":"3","key":"pcbi.1008849.ref025","doi-asserted-by":"crossref","first-page":"e74","DOI":"10.1371\/journal.pmed.0050074","article-title":"Social contacts and mixing patterns relevant to the spread of infectious diseases","volume":"5","author":"J Mossong","year":"2008","journal-title":"PLoS Med"},{"issue":"9","key":"pcbi.1008849.ref026","doi-asserted-by":"crossref","first-page":"e1005697","DOI":"10.1371\/journal.pcbi.1005697","article-title":"Projecting social contact matrices in 152 countries using contact surveys and demographic data","volume":"13","author":"K Prem","year":"2017","journal-title":"PLoS computational biology"},{"key":"pcbi.1008849.ref027","article-title":"Forecasting the scale of the covid-19 epidemic in kenya","author":"SPC Brand","year":"2020","journal-title":"medRxiv"},{"key":"pcbi.1008849.ref028","first-page":"1","article-title":"COVID- 19 Infection in Children: Estimating Pediatric Morbidity and Mortality","author":"M Barton","year":"2020","journal-title":"medRxiv preprint"},{"issue":"6","key":"pcbi.1008849.ref029","doi-asserted-by":"crossref","first-page":"e20200702","DOI":"10.1542\/peds.2020-0702","article-title":"Epidemiology of COVID-19 Among Children in China","volume":"145","author":"Y Dong","year":"2020","journal-title":"Pediatrics"},{"key":"pcbi.1008849.ref030","article-title":"Susceptibility to and transmission of COVID-19 amongst children and adolescents compared with adults: a systematic review and meta-analysis","author":"RM Viner","year":"2020","journal-title":"medRxiv"},{"key":"pcbi.1008849.ref031","article-title":"Assessment of workers personal vulnerability to covid-19 using covid-age","author":"D Coggon","year":"2020","journal-title":"medRxiv"},{"key":"pcbi.1008849.ref032","article-title":"Opensafely: factors associated with covid-19-related hospital death in the linked electronic health records of 17 million adult nhs patients","author":"E Williamson","year":"2020","journal-title":"MedRxiv"},{"key":"pcbi.1008849.ref033","unstructured":"Royal college of general practitioners (rcgp) research and surveillance centre. https:\/\/www.rcgp.org.uk\/clinical-and-research\/our-programmes\/research-and-surveillance-centre.aspx (accessed June, 2020)."},{"key":"pcbi.1008849.ref034","unstructured":"Audit ND. National diabetes audit mortality analysis 2018. NHS digital (2018)."},{"key":"pcbi.1008849.ref035","unstructured":"UK CR. Cancer incidence by age. https:\/\/www.cancerresearchuk.org\/health-professional\/cancer-statistics\/incidence\/age#heading-Zero (accessed June, 2020)."},{"issue":"7","key":"pcbi.1008849.ref036","doi-asserted-by":"crossref","first-page":"e375","DOI":"10.1016\/S2468-2667(20)30133-X","article-title":"Effects of non-pharmaceutical interventions on COVID-19 cases, deaths, and demand for hospital services in the UK: a modelling study","volume":"5","author":"NG Davies","year":"2020","journal-title":"Lancet Public Heal"},{"key":"pcbi.1008849.ref037","volume-title":"Infectious diseases of humans: dynamics and control","author":"RM Anderson","year":"1992"},{"key":"pcbi.1008849.ref038","doi-asserted-by":"crossref","DOI":"10.2307\/j.ctvcm4gk0","volume-title":"Modeling infectious diseases in humans and animals","author":"MJ Keeling","year":"2011"},{"key":"pcbi.1008849.ref039","article-title":"The early landscape of covid-19 vaccine development in the uk and rest of the world","author":"HR Sharpe","year":"2020","journal-title":"Immunology"},{"issue":"21","key":"pcbi.1008849.ref040","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1056\/NEJMp2005630","article-title":"Developing covid-19 vaccines at pandemic speed","volume":"382","author":"N Lurie","year":"2020","journal-title":"New England Journal of Medicine"},{"key":"pcbi.1008849.ref041","article-title":"Risk of covid-19 among front-line health-care workers and the general community: a prospective cohort study","author":"LH Nguyen","year":"2020","journal-title":"The Lancet Public Health"},{"key":"pcbi.1008849.ref042","unstructured":"Digital N. Nhs workforce statistics- feb 2020. https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/nhs-workforce-statistics\/february-2020 (accessed July, 2020)."},{"key":"pcbi.1008849.ref043","article-title":"Antibody response to influenza vaccination in the elderly: a quantitative review","author":"K Goodwin","year":"2006","journal-title":"Vaccine"},{"key":"pcbi.1008849.ref044","article-title":"Community prevalence of sars-cov-2 virus in england during may 2020: React study","author":"S Riley","year":"2020","journal-title":"medRxiv"},{"issue":"58","key":"pcbi.1008849.ref045","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1098\/rsif.2010.0474","article-title":"Targeting vaccination against novel infections: risk, age and spatial structure for pandemic influenza in great britain","volume":"8","author":"MJ Keeling","year":"2011","journal-title":"Journal of the Royal Society Interface"},{"key":"pcbi.1008849.ref046","unstructured":"Public Health England. Official Statistics: Annual flu reports (2020). https:\/\/www.gov.uk\/government\/statistics\/annual-flu-reports. [Online] (Accessed: 11 December 2020)."},{"key":"pcbi.1008849.ref047","article-title":"Inadequate intention to receive Covid-19 vaccination: indicators for public health messaging needed to improve uptake in UK","author":"P Bachtiger","year":"2020","journal-title":"medRxiv"},{"key":"pcbi.1008849.ref048","unstructured":"Office for National Statistics. Coronavirus and the social impacts on Great Britain: 18 December 2020 (2020). https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/healthandwellbeing\/bulletins\/coronavirusandthesocialimpactsongreatbritain\/18december2020. [Online] (Accessed: 18 December 2020)."},{"key":"pcbi.1008849.ref049","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1098\/rspb.1999.0716","article-title":"The effects of local spatial structure on epidemiological invasions","volume":"266","author":"MJ Keeling","year":"1999","journal-title":"Proc. R. Soc. Lond. B"},{"issue":"38","key":"pcbi.1008849.ref050","doi-asserted-by":"crossref","first-page":"6472","DOI":"10.1016\/j.vaccine.2011.06.107","article-title":"Factors associated with uptake of vaccination against pandemic influenza: A systematic review","volume":"29","author":"A Bish","year":"2011","journal-title":"Vaccine"},{"key":"pcbi.1008849.ref051","first-page":"1","article-title":"COVID-19 vaccination intention in the UK: results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey","author":"SM Sherman","year":"2020","journal-title":"Hum. Vaccin. Immunother"},{"issue":"27","key":"pcbi.1008849.ref052","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine","volume":"383","author":"FP Polack","year":"2020","journal-title":"N. Engl. J. Med"},{"issue":"10269","key":"pcbi.1008849.ref053","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0140-6736(20)32661-1","article-title":"Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK","volume":"397","author":"M Voysey","year":"2021","journal-title":"Lancet"},{"key":"pcbi.1008849.ref054","article-title":"Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine","author":"LR Baden","year":"2020","journal-title":"N. Engl. J. Med"},{"key":"pcbi.1008849.ref055","unstructured":"World Health Organisation. Vaccination\u2014WHO\/Europe | Influenza (2020). https:\/\/www.euro.who.int\/en\/health-topics\/communicable-diseases\/influenza\/vaccination. [Online] (Accessed: 17 December 2020)."},{"issue":"5","key":"pcbi.1008849.ref056","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1038\/s41562-020-0884-z","article-title":"Using social and behavioural science to support COVID-19 pandemic response","volume":"4","author":"JJV Bavel","year":"2020","journal-title":"Nat. Hum. Behav"}],"container-title":["PLOS Computational Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pcbi.1008849","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T13:31:50Z","timestamp":1620307910000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pcbi.1008849"}},"subtitle":[],"editor":[{"given":"Alex","family":"Perkins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,5,6]]},"references-count":56,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,6]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pcbi.1008849","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.09.22.20194183","asserted-by":"object"}]},"ISSN":["1553-7358"],"issn-type":[{"value":"1553-7358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,6]]}}}