Real-time monitoring and predictive modelling of the impact of human behaviour and vaccine characteristics on COVID-19 vaccination in Scotland

Lead Research Organisation: University of Edinburgh
Department Name: The Roslin Institute

Abstract

While COVID-19 vaccination will likely be transformative, many uncertainties may influence how quickly and comprehensively vaccination will have an impact. Current evidence suggests high levels of protection from the available vaccines, with some evidence that it also reduces transmission. However the evaluation of the evidence is ongoing, with the potential for new variants of concern to change the overall picture. To evaluate this in real time, we shall address here two interlinked factors: the potential for vaccinated individuals to shed and transmit virus without displaying clinical symptoms, and the rate of vaccination uptake and how it may cluster in communities. We shall work with Public Health Scotland, to exploit real-time monitoring of vaccine uptake, COVID-19 testing and cases, to identify geographical localised impacts on infection rates. Wastewater surveillance data will help to identify possible shedding of vaccinated individuals by comparing detection rates before and after vaccination, with a signal either indicating potential for transmission or a signal that must be accounted for to reduce the likelihood of false alarms in future situations where wastewater surveillance is being utilised.

Using an established agent-based model fitted to cases across Scotland, we shall use these data to make short term forecasts for COVID-19 case numbers to support PHS planning. Long-term projections will consider vaccine-induced and natural immunity, clustering of low vaccine uptake, logistics, and possible loss of immunity. An online survey will build on the ongoing OPTIMUM study by correlating vaccination attitudes and ease of access to Scottish demography, mapping these geographically via the Scottish index of multiple deprivation (SIMD). We shall use models of 'vaccination games' to consider possible future scenarios where combinations of hesitancy, refusal and difficulties of access could result in lower uptake rates in some communities and therefore continued higher levels of infection or risk of outbreaks. We shall embed these scenarios into our simulation models. From this project, we shall have a more refined understanding of COVID-19 epidemiology in Scotland under vaccination, and better predictions of epidemic trajectories to aid in planning, to inform possible stresses on hospitals and ICU, and to target vaccine deployment and information strategies. Our results will more generally inform relationships amongst vaccine attitudes, accessibility, and regions of low vaccine uptake and refine approaches to surveillance and control.
 
Description A machine learning analysis of geographical vaccination uptake patterns shows that uptake is well predicted by a combination of geographical demographics at the data zone (1000+ individual residents) level, using deprivation, age, gender and ethnicity, if you impose an overall uptake rate. This pattern worked on describing the distribution of uptake of vaccines when overall uptake declined by approximately 10% across booster campaigns in Scotland. Importantly the prediction was made without any specially collected data, only what is routinely collected not just in Scotland but elsewhere. The approach could also could be used for other vaccines (e.g. influenza).
Exploitation Route Models to generate the outcomes are available on github site - additional funding to create user friendly apps and documentation would aid in it being adopted more broadly.
Sectors Healthcare

URL https://www.medrxiv.org/content/10.1101/2022.08.30.22279415v2
 
Description BBC Scotland news item on how wastewater surveillance could be used in a 'living with COVID' future. Vaccination reports have been used by the Scottish Govt and health boards to aid in operational planning of the vaccination campaign during the COVID-19 pandemic.
First Year Of Impact 2022
Sector Healthcare
Impact Types Societal

 
Description Member of PHS Genomic Epidemiology Intelligence Consortium (GenEPIC)
Geographic Reach National 
Policy Influence Type Participation in a guidance/advisory committee
Impact The implementation and interpretation of pathogen genetic data now regularly informs healthcare decisions at the national level, with a particular example being the ongoing assessment of COVID-19 risks in Scotland. This body, as an oversight group, contributes to assurance that these often new technologies are subject to robust use and interpretation.
 
Description Models to inform Public Health Scotland Policy on COVID-19 controls
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact Models developed at the Roslin Institute have been used to provide projections of COVID-19 in Scotland, to aid in the determination of Scottish tier levels (i.e. restrictions to control COVID-19). As these restrictions have widespread influence on Scotland as a whole, the impact is extremely broad. The projections used are based on a published preprint (currently under review) - doi: https://doi.org/10.1101/2020.11.25.20144139. Vaccine uptake analyses are used to improve planning for the COVID vaccination programme.
URL https://www.gov.scot/collections/coronavirus-covid-19-modelling-the-epidemic/
 
Description Reports on COVID-19 trajectories in Scotland
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
Impact The reports provided to the Scottish government supported implementation of policy on COVID-19 controls. While the contribution of the reports are difficult to quantify, overall COVID-19 controls resulted in substantial reduction in severe illness and mortality due to COVID-19.
URL https://www.gov.scot/collections/coronavirus-covid-19-modelling-the-epidemic/
 
Description Reports on COVID-19 vaccine uptake to Scottish govt
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
Impact The reports contributed to the effective distribution of COVID-19 vaccines in Scotland. While the extent to which these reports were influential is difficult to assess, overall the COVID-19 vaccine is known to be extremely effective against severe illness and mortality, and the vaccination campaign facilitated the reduction and ultimate removal of non-pharmaceutical interventions against COVID-19.
 
Description Spatial And Network Analysis Of SARS-Cov-2 Sequences To Inform COVID-19 Control In Scotland
Amount £299,037 (GBP)
Funding ID HIPS/21/71 
Organisation Chief Scientist Office 
Sector Public
Country United Kingdom
Start 05/2022 
End 12/2023
 
Description BBC Scotland (The Sunday Show) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Interview on BBC Scotand's Sunday Show, discussing the emergence of the "Pirola" SARS-CoV-2 variant and the role of future interventions in controlling it.
Year(s) Of Engagement Activity 2023
URL https://www.bbc.co.uk/news/uk-scotland-66767409.amp
 
Description BBC Scotland News feature 13th May 2021 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Interview and feature story on BBC Scotland 7pm News on 13th May 2021. Story was about our research project and how its results could be used to inform future COVID-19 surveillance, and control, including exploiting wastewater surveillance, and improving uptake of vaccines in socially deprived areas.
Year(s) Of Engagement Activity 2021
 
Description Interview on STV 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact An interview on the utility of WW surveillance for detecting SARS-CoV-2
Year(s) Of Engagement Activity 2022
URL https://news.stv.tv/scotland/scottish-scientists-sift-through-sewage-to-catch-new-variants-of-corona...
 
Description iNews opinion piece - It's an easy choice to offer the Covid vaccine to 16 and 17-year-olds, despite little new evidence emerging 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact An opinion piece, explaining reasons why COVID vaccination extended to younger age groups was a sensible strategy based on the evidence available at the time.
Year(s) Of Engagement Activity 2021
URL https://inews.co.uk/opinion/covid-vaccine-16-17-year-olds-offered-jab-no-changes-evidence-1136353