Impact of the 100 days mission for vaccines on COVID-19: a mathematical modelling study.

Background: The COVID-19 pandemic has underscored the beneficial impact of vaccines. It also highlighted the need for future investments to expedite an equitable vaccine distribution. The 100 Days Mission aims to develop and make available a new vaccine against a future pathogen with pandemic potential within 100 days of that pathogen threat being recognised. We assessed the value of this mission by estimating the impact that it could have had on the COVID-19 pandemic.
Methods: Using a previously published model of SARS-CoV-2 transmission dynamics fitted to excess mortality during the COVID-19 pandemic, we projected scenarios for three different investment strategies: rapid development and manufacture of a vaccine, increasing manufacturing capacity to eliminate supply constraints, and strengthening health systems to enable faster vaccine roll-outs and global equity. Each scenario was compared against the observed COVID-19 pandemic to estimate the public health and health-economic impacts of each scenario.
Findings: If countries implemented non-pharmaceutical interventions (NPIs) as they did historically, the 100 Days Mission could have averted an estimated 8·33 million deaths (95% credible interval [CrI] 7·70-8·68) globally, mostly in lower-middle income countries. This corresponds to a monetary saving of US$14·35 trillion (95% CrI 12·96-17·87) based on the value of statistical life-years saved. Investment in manufacturing and health systems further increases deaths averted to 11·01 million (95% CrI 10·60-11·49). Under an alternative scenario whereby NPIs are lifted earlier on the basis of vaccine coverage, the 100 Days Mission alone could have reduced restrictions by 12 600 days (95% CrI 12 300-13 100) globally while still averting 5·76 million deaths (95% CrI 4·91-6·81).
Interpretation: Our findings show the value of the 100 Days Mission and how these can be amplified through improvements in manufacturing and health systems equity. However, these investments must be enhanced by prioritising a more equitable global vaccine distribution.
Funding: Schmidt Science Fellowship in partnership with the Rhodes Trust, WHO, UK Medical Research Council, Coalition for Epidemic Preparedness Innovations.
Competing Interests: Declaration of interests The Coalition for Epidemic Preparedness Innovations (CEPI) funded the investigation into the impact of the 100 Days Mission. The authors maintained full freedom when designing the study and deciding on additional scenarios to explore. ACG has received personal consultancy fees from HSBC, GlaxoSmithKline, Sanofi, and WHO related to COVID-19 epidemiology and from The Global Fund to Fight AIDS, Tuberculosis and Malaria for work unrelated to COVID-19. ACG was previously a non-remunerated member of a scientific advisory board for Moderna and is a non-remunerated member of the scientific advisory board for the Coalition for Epidemic Preparedness; has received personal consultancy fees from WHO for work related to malaria. OJW also received personal consultancy fees from WHO and the Clinton Health Access Initiative for work related to malaria. ABH has received personal consultancy fees from WHO for work related to COVID-19, and grant funding for COVID-19 work from WHO and NSW Ministry of Health, Australia; and is a member of the WHO Immunization and Vaccines Related Implementation Research Advisory Committee. AAT developed the allocation algorithm in collaboration with COVAX through funding from the Bill & Melinda Gates Foundation. All other authors declare no competing interests.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)