Throughout 2020 and the first part of 2021, Australia and New Zealand have followed a COVID-19 elimination strategy. Both countries require overseas arrivals to quarantine in government-managed facilities at the border. In both countries, community outbreaks of COVID-19 have been started via infection of a border worker. This workforce is rightly being prioritized for vaccination. However, although vaccines are highly effective in preventing disease, their effectiveness in preventing infection with and transmission of SARS-CoV-2 is less certain. There is a danger that vaccination could prevent symptoms of COVID-19 but not prevent transmission. Here, we use a stochastic model of SARS-CoV-2 transmission and testing to investigate the effect that vaccination of border workers has on the risk of an outbreak in an unvaccinated community. We simulate the model starting with a single infected border worker and measure the number of people who are infected before the first case is detected by testing. We show that if a vaccine reduces transmission by 50%, vaccination of border workers increases the risk of a major outbreak from around 7% per seed case to around 9% per seed case. The lower the vaccine effectiveness against transmission, the higher the risk. The increase in risk as a result of vaccination can be mitigated by increasing the frequency of routine testing for high-exposure vaccinated groups.
【저자키워드】 Vaccines, quarantine, epidemic model, surveillance testing, COVID-19 elimination, 【초록키워드】 COVID-19, Vaccine, vaccination, Infection, risk, Transmission, SARS-CoV-2 transmission, outbreak, Effectiveness, Community, Frequency, symptoms of COVID-19, transmission of SARS-CoV-2, country, Prevent, effective, increase, less, increase in, reduce, groups, the vaccine, New, preventing disease, preventing infection, 【제목키워드】 COVID-19, risk, Community,