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  1. Article ; Online: The Unrecognized Death Toll of COVID-19 in the United States.

    Moghadas, Seyed M / Galvani, Alison P

    Lancet Regional Health. Americas

    2021  Volume 1, Page(s) 100033

    Language English
    Publishing date 2021-08-10
    Publishing country England
    Document type Journal Article
    ISSN 2667-193X
    ISSN (online) 2667-193X
    DOI 10.1016/j.lana.2021.100033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Modelling the effect of travel-related policies on disease control in a meta-population structure.

    Xu, Jingjing / Wang, Zhen / Moghadas, Seyed M

    Journal of mathematical biology

    2023  Volume 87, Issue 4, Page(s) 55

    Abstract: Travel restrictions, while delaying the spread of an emerging disease from the source, could inflict substantial socioeconomic burden. Travel-related policies, such as quarantine and testing of travelers, may be considered as alternative strategies to ... ...

    Abstract Travel restrictions, while delaying the spread of an emerging disease from the source, could inflict substantial socioeconomic burden. Travel-related policies, such as quarantine and testing of travelers, may be considered as alternative strategies to mitigate the negative impact of travel bans. We developed a meta-population, delay-differential model to evaluate a strategy that combines testing of travelers prior to departure from the source of infection with quarantine and testing at exit from quarantine in the destination population. Our results, based on early parameter estimates of SARS-CoV-2 infection, indicate that testing travelers at exit from quarantine is more effective in delaying case importation than testing them before departure or upon arrival. We show that a 1-day quarantine with an exit test could outperform a longer, 3-day quarantine without testing in delaying the outbreak peak. Rapid, large-scale testing capacities with short turnaround times provide important means of detecting infectious cases and reducing case importation, while shortening quarantine duration for travelers at destination.
    MeSH term(s) Humans ; COVID-19/epidemiology ; COVID-19/prevention & control ; SARS-CoV-2 ; Travel ; Travel-Related Illness ; Policy
    Language English
    Publishing date 2023-09-09
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 187101-8
    ISSN 1432-1416 ; 0303-6812
    ISSN (online) 1432-1416
    ISSN 0303-6812
    DOI 10.1007/s00285-023-01990-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Epidemic dynamics with time-varying transmission risk reveal the role of disease stage-dependent infectiousness.

    Li, Ao / Wu, Jianhong / Moghadas, Seyed M

    Journal of theoretical biology

    2023  Volume 573, Page(s) 111594

    Abstract: A key characteristic of acute communicable diseases is the infectiousness that varies over time as the infection dynamics evolve within a host, which influences the risk of transmission in different stages of the disease. Despite the evidence of time- ... ...

    Abstract A key characteristic of acute communicable diseases is the infectiousness that varies over time as the infection dynamics evolve within a host, which influences the risk of transmission in different stages of the disease. Despite the evidence of time-varying transmission risk, most dynamic models of epidemics assume a constant transmission rate during the infectious period. Recent work has shown the difference in epidemic dynamics when this assumption is relaxed and different transmission rates are used by discretizing the infectious period into multiple sub-periods. Here, we develop an age-structured model to integrate a continuous time-varying transmission risk, based on an established correlation between the viral dynamics and infectiousness profile. Taking into account the natural history and parameter estimates of COVID-19 caused by the original strain of SARS-CoV-2, we demonstrate the difference in temporal epidemic dynamics when a continuous time-varying transmission probability is used as compared to multiple constant transmission probabilities. Our results show a significant difference between the incidence curves in terms of the magnitude and peak time, even when the reproduction number and total number of infections are the same for continuous and discrete transmission probabilities. Finally, we demonstrate the spurious outcome of preventing an epidemic through the isolation of infectious individuals when constant transmission probabilities are used, highlighting the importance of integrating a continuous time-dependent transmission parameter in dynamic models. These findings suggest a more cautious interpretation of model outcomes, especially those that are intended to evaluate the effectiveness of interventions and inform policy decisions for disease mitigation strategies.
    MeSH term(s) Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Epidemics/prevention & control ; Probability ; Policy
    Language English
    Publishing date 2023-08-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2972-5
    ISSN 1095-8541 ; 0022-5193
    ISSN (online) 1095-8541
    ISSN 0022-5193
    DOI 10.1016/j.jtbi.2023.111594
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Modelling the impact of timelines of testing and isolation on disease control.

    Li, Ao / Wang, Zhen / Moghadas, Seyed M

    Infectious Disease Modelling

    2022  Volume 8, Issue 1, Page(s) 58–71

    Abstract: Testing and isolation remain a key component of public health responses to both persistent and emerging infectious diseases. Although the value of these measures have been demonstrated in combating recent outbreaks including the COVID-19 pandemic and ... ...

    Abstract Testing and isolation remain a key component of public health responses to both persistent and emerging infectious diseases. Although the value of these measures have been demonstrated in combating recent outbreaks including the COVID-19 pandemic and monkeypox, their impact depends critically on the timelines of testing and start of isolation during the course of disease. To investigate this impact, we developed a delay differential model and incorporated age-since-symptom-onset as a parameter for delay in testing. We then used the model to compare the outcomes of reverse-transcription polymerase chain reaction (RT-PCR) and rapid antigen (RA) testing methods when isolation starts either at the time of testing or at the time of test result. Parameterizing the model with estimates of SARS-CoV-2 infection and diagnostic sensitivity of the tests, we found that the reduction of disease transmission using the RA test can be comparable to that achieved by applying the RT-PCR test. Given constraints and inevitable delays associated with sample collection and laboratory assays in RT-PCR testing post symptom onset, self-administered RA tests with short turnaround times present a viable alternative for timely isolation of infectious cases.
    Language English
    Publishing date 2022-11-28
    Publishing country China
    Document type Journal Article
    ZDB-ID 3015225-2
    ISSN 2468-0427 ; 2468-2152
    ISSN (online) 2468-0427
    ISSN 2468-2152
    DOI 10.1016/j.idm.2022.11.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Cost-effectiveness analysis of nirsevimab and maternal RSVpreF vaccine strategies for prevention of Respiratory Syncytial Virus disease among infants in Canada: a simulation study.

    Shoukat, Affan / Abdollahi, Elaheh / Galvani, Alison P / Halperin, Scott A / Langley, Joanne M / Moghadas, Seyed M

    Lancet regional health. Americas

    2023  Volume 28, Page(s) 100629

    Abstract: ... the Canadian Institutes of Health Research (CIHR). Seyed M. Moghadas acknowledges support ...

    Abstract Background: The cost-effectiveness of immunisation strategies with a long-acting monoclonal antibody (nirsevimab) and/or a protein-based maternal vaccine (RSVpreF) for protecting infants from Respiratory Syncytial Virus (RSV)-associated illness has not been previously determined for Canada. We estimated the health benefits and cost-effectiveness of nirsevimab for immunising the entire birth cohort, regardless of gestational age or other risk factors. Additionally, we evaluated the health benefits and cost-effectiveness of a combined strategy of year-round vaccination of pregnant women with RSVpreF and immunisation of infants at high risk, including those born preterm or with chronic conditions, with nirsevimab during the RSV season.
    Methods: We developed a discrete-event simulation model, parameterized with the data on medically-attended RSV infections among infants under one year of age from 2010 to 2019, including outpatient care, hospitalisations, and deaths. Intervention scenarios targeting twelve monthly birth cohorts and pregnant women, reflecting the 2021 census data for Ontario, Canada were evaluated over a follow-up time horizon of one year from birth. Taking into account the costs (in 2023 Canadian dollars) associated with RSV-related outcomes, we calculated the net monetary benefit using the quality-adjusted life-year (QALY) gained. Further, we determined the range of price-per-dose (PPD) for nirsevimab and RSVpreF within which the program was cost-effective. Cost-effectiveness analyses were conducted from both healthcare and societal perspectives.
    Findings: Using a willingness-to-pay of CAD$50,000 per QALY gained, we found that immunising the entire birth cohort with nirsevimab would be cost-effective from a societal perspective for a PPD of up to $290, with an annual budget impact of $83,978 for 1113 infants per 100,000 population. An alternative, combined strategy of vaccinating pregnant women and immunising only infants at high risk of severe disease would lead to a lower budget impact of $49,473 per 100,000 population with a PPD of $290 and $195 for nirsevimab and RSVpreF vaccine, respectively. This combined strategy would reduce infant mortality by 76%-85%, comparable to a 78% reduction achieved through a nirsevimab-only program of the entire birth cohort. The PPD for cost-effective programs with nirsevimab was sensitive to the target population among infants.
    Interpretation: Passive immunisation of infants under 6 months of age with nirsevimab and vaccination of pregnant women with RSVpreF could be a cost-effective strategy for protecting infants during their first RSV season.
    Funding: This study was supported by the Canadian Immunisation Research Network (CIRN) and the Canadian Institutes of Health Research (CIHR). Seyed M. Moghadas acknowledges support from the Natural Sciences and Engineering Research Council of Canada (MfPH and Discovery grants). Alison P. Galvani acknowledges support from the The Notsew Orm Sands Foundation.
    Language English
    Publishing date 2023-11-09
    Publishing country England
    Document type Journal Article
    ISSN 2667-193X
    ISSN (online) 2667-193X
    DOI 10.1016/j.lana.2023.100629
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Ten years of Pan-InfORM: modelling research for public health in Canada.

    Tariq, Mehreen / Haworth-Brockman, Margaret / Moghadas, Seyed M

    AIMS public health

    2021  Volume 8, Issue 2, Page(s) 265–274

    Abstract: Modelling and simulation methods can play an important role in guiding public health responses to infectious diseases and emerging health threats by projecting the plausible outcomes of decisions and interventions. The 2003 SARS epidemic marked a new ... ...

    Abstract Modelling and simulation methods can play an important role in guiding public health responses to infectious diseases and emerging health threats by projecting the plausible outcomes of decisions and interventions. The 2003 SARS epidemic marked a new chapter in disease modelling in Canada as it triggered a national discussion on the utility and uptake of modelling research in local and pandemic outbreaks. However, integration and application of model-based outcomes in public health requires knowledge translation and contextualization. We reviewed the history and performance of Pan-InfORM (Pandemic Influenza Outbreak Research Modelling), which created a national infrastructure in Canada with a mandate to develop innovative knowledge translation methodologies to inform policy makers through modelling frameworks that bridge the gaps between theory, policy, and practice. This review demonstrates the importance of a collaborative infrastructure as a "Community of Practice" to guide public health responses, especially in the context of emerging diseases with substantial uncertainty, such as the COVID-19 pandemic. Dedicated resources to modelling and knowledge translation activities can help create synergistic strategies at the global scale and optimize public health responses to protect at-risk populations and quell socioeconomic and health burden.
    Language English
    Publishing date 2021-03-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2777115-5
    ISSN 2327-8994 ; 2327-8994
    ISSN (online) 2327-8994
    ISSN 2327-8994
    DOI 10.3934/publichealth.2021020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Impact and cost-effectiveness analyses of vaccination for prevention of respiratory syncytial virus disease among older adults in Ontario: A Canadian Immunization Research Network (CIRN) study.

    Shoukat, Affan / Bawden, Carolyn E / Röst, Gergely / LeBlanc, Jason J / Galvani, Alison P / Langley, Joanne M / Moghadas, Seyed M

    Vaccine

    2024  Volume 42, Issue 7, Page(s) 1768–1776

    Abstract: Background: Two prefusion F protein-based vaccines, Arexvy and Abrysvo, have been approved by Health Canada for protecting older adults against respiratory syncytial virus (RSV)-associated lower respiratory tract disease. We estimated the health ... ...

    Abstract Background: Two prefusion F protein-based vaccines, Arexvy and Abrysvo, have been approved by Health Canada for protecting older adults against respiratory syncytial virus (RSV)-associated lower respiratory tract disease. We estimated the health benefits and cost-effectiveness of these vaccines under a publicly funded single-dose vaccination program in Ontario that targets residents of long-term care homes (LTCHs). Additionally, we evaluated an extended program that broadens vaccination to include community-dwelling older adults.
    Methods: A discrete-event simulation model was parameterised with the burden of RSV disease including outpatient care, hospitalisation, and death among adults aged 60 years or older in Ontario, Canada. Accounting for direct and indirect costs (in 2023 Canadian dollars) associated with RSV-related outcomes, we calculated the net monetary benefit using quality-adjusted life-year (QALY) gained, and determined the range of price-per-dose (PPD) for vaccination programs to be cost-effective from both healthcare and societal perspectives over two RSV seasons. The incremental cost-effectiveness ratio (ICER) was calculated to estimate the additional costs required to gain one QALY.
    Results: Using a willingness-to-pay of $50,000 per QALY gained, we found that vaccinating 90% of residents in LTCHs with Arexvy would be cost-effective from a societal perspective for a PPD up to $163, producing a mean ICER value of $49,984 (95% CI: $47,539 to $52,704) per QALY gained with a two-year budget impact of $463,468 per 100,000 older adults. The reduction of hospitalizations was estimated at 7.0% compared to the no-vaccination scenario. Extending the program to include community-dwelling older adults with a 74% coverage akin to influenza vaccination, Arexvy remains cost-effective for a PPD up to $139, with a mean ICER value of $49,698 (95% CI: 48,022 to 51,388) per QALY gained and a two-year budget impact of $8.63 million. Compared to the no-vaccination scenario, the extended program resulted in a 57.3% reduction in RSV-related hospitalisations.
    Conclusions: Vaccinating residents of LTCHs against RSV disease would be cost-effective depending on PPD; extending the program to community-dwelling older adults would provide substantial health benefits, averting significant direct healthcare costs and productivity losses.
    MeSH term(s) Humans ; Aged ; Cost-Benefit Analysis ; Ontario ; Respiratory Syncytial Virus Infections/prevention & control ; Vaccination ; Communicable Diseases ; Respiratory Syncytial Virus, Human ; Vaccines ; Quality-Adjusted Life Years ; Viral Vaccines ; Respiratory Syncytial Virus Vaccines
    Chemical Substances abrysvo ; arexvy ; Vaccines ; Viral Vaccines ; Respiratory Syncytial Virus Vaccines
    Language English
    Publishing date 2024-02-16
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2024.02.041
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  8. Article ; Online: Evaluation of Strategies for Transitioning to Annual SARS-CoV-2 Vaccination Campaigns in the United States.

    Wells, Chad R / Pandey, Abhishek / Moghadas, Seyed M / Fitzpatrick, Meagan C / Singer, Burton H / Galvani, Alison P

    Annals of internal medicine

    2024  

    Abstract: Background: The U.S. Food and Drug Administration has proposed administering annual SARS-CoV-2 vaccines.: Objective: To evaluate the effectiveness of an annual SARS-CoV-2 vaccination campaign, quantify the health and economic benefits of a second ... ...

    Abstract Background: The U.S. Food and Drug Administration has proposed administering annual SARS-CoV-2 vaccines.
    Objective: To evaluate the effectiveness of an annual SARS-CoV-2 vaccination campaign, quantify the health and economic benefits of a second dose provided to children younger than 2 years and adults aged 50 years or older, and optimize the timing of a second dose.
    Design: An age-structured dynamic transmission model.
    Setting: United States.
    Participants: A synthetic population reflecting demographics and contact patterns in the United States.
    Intervention: Vaccination against SARS-CoV-2 with age-specific uptake similar to that of influenza vaccination.
    Measurements: Incidence, hospitalizations, deaths, and direct health care cost.
    Results: The optimal timing between the first and second dose delivered to children younger than 2 years and adults aged 50 years or older in an annual vaccination campaign was estimated to be 5 months. In direct comparison with a single-dose campaign, a second booster dose results in 123 869 fewer hospitalizations (95% uncertainty interval [UI], 121 994 to 125 742 fewer hospitalizations) and 5524 fewer deaths (95% UI, 5434 to 5613 fewer deaths), averting $3.63 billion (95% UI, $3.57 billion to $3.69 billion) in costs over a single year.
    Limitations: Population immunity is subject to degrees of immune evasion for emerging SARS-CoV-2 variants. The model was implemented in the absence of nonpharmaceutical interventions and preexisting vaccine-acquired immunity.
    Conclusion: The direct health care costs of SARS-CoV-2, particularly among adults aged 50 years or older, would be substantially reduced by administering a second dose 5 months after the initial dose.
    Primary funding source: Natural Sciences and Engineering Research Council of Canada, Notsew Orm Sands Foundation, National Institutes of Health, Centers for Disease Control and Prevention, and National Science Foundation.
    Language English
    Publishing date 2024-03-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/M23-2451
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Estimated US Pediatric Hospitalizations and School Absenteeism Associated With Accelerated COVID-19 Bivalent Booster Vaccination.

    Fitzpatrick, Meagan C / Moghadas, Seyed M / Vilches, Thomas N / Shah, Arnav / Pandey, Abhishek / Galvani, Alison P

    JAMA network open

    2023  Volume 6, Issue 5, Page(s) e2313586

    Abstract: Importance: Adverse outcomes of COVID-19 in the pediatric population include disease and hospitalization, leading to school absenteeism. Booster vaccination for eligible individuals across all ages may promote health and school attendance.: Objective!# ...

    Abstract Importance: Adverse outcomes of COVID-19 in the pediatric population include disease and hospitalization, leading to school absenteeism. Booster vaccination for eligible individuals across all ages may promote health and school attendance.
    Objective: To assess whether accelerating COVID-19 bivalent booster vaccination uptake across the general population would be associated with reduced pediatric hospitalizations and school absenteeism.
    Design, setting, and participants: In this decision analytical model, a simulation model of COVID-19 transmission was fitted to reported incidence data from October 1, 2020, to September 30, 2022, with outcomes simulated from October 1, 2022, to March 31, 2023. The transmission model included the entire age-stratified US population, and the outcome model included children younger than 18 years.
    Interventions: Simulated scenarios of accelerated bivalent COVID-19 booster campaigns to achieve uptake that was either one-half of or similar to the age-specific uptake observed for 2020 to 2021 seasonal influenza vaccination in the eligible population across all age groups.
    Main outcomes and measures: The main outcomes were estimated hospitalizations, intensive care unit admissions, and isolation days of symptomatic infection averted among children aged 0 to 17 years and estimated days of school absenteeism averted among children aged 5 to 17 years under the accelerated bivalent booster campaign simulated scenarios.
    Results: Among children aged 5 to 17 years, a COVID-19 bivalent booster campaign achieving age-specific coverage similar to influenza vaccination could have averted an estimated 5 448 694 (95% credible interval [CrI], 4 936 933-5 957 507) days of school absenteeism due to COVID-19 illness. In addition, the booster campaign could have prevented an estimated 10 019 (95% CrI, 8756-11 278) hospitalizations among the pediatric population aged 0 to 17 years, of which 2645 (95% CrI, 2152-3147) were estimated to require intensive care. A less ambitious booster campaign with only 50% of the age-specific uptake of influenza vaccination among eligible individuals could have averted an estimated 2 875 926 (95% CrI, 2 524 351-3 332 783) days of school absenteeism among children aged 5 to 17 years and an estimated 5791 (95% CrI, 4391-6932) hospitalizations among children aged 0 to 17 years, of which 1397 (95% CrI, 846-1948) were estimated to require intensive care.
    Conclusions and relevance: In this decision analytical model, increased uptake of bivalent booster vaccination among eligible age groups was associated with decreased hospitalizations and school absenteeism in the pediatric population. These findings suggest that although COVID-19 prevention strategies often focus on older populations, the benefits of booster campaigns for children may be substantial.
    MeSH term(s) Child ; Humans ; Influenza, Human/prevention & control ; Absenteeism ; Health Promotion ; COVID-19/epidemiology ; COVID-19/prevention & control ; Vaccination ; Hospitalization ; Schools
    Language English
    Publishing date 2023-05-01
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Research Support, Non-U.S. Gov't
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.13586
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: The Unrecognized Death Toll of COVID-19 in the United States

    Seyed M. Moghadas / Alison P. Galvani

    The Lancet Regional Health. Americas, Vol 1, Iss , Pp 100033- (2021)

    2021  

    Keywords Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2021-09-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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