Photo by Samantha Gades on Unsplash
Photo by Samantha Gades on Unsplash

The unvaccinated increase the risk of COVID-19 for the vaccinated when they mingle

Embargoed until: Publicly released:
Peer-reviewed: This work was reviewed and scrutinised by relevant independent experts.

Simulation/modelling: This type of study uses a computer simulation or mathematical model to predict an outcome. The original values put into the model may have come from real-world measurements (eg: past spread of a disease used to model its future spread).

People who have been vaccinated are substantially more at risk of COVID-19 infection when they mingle with people who are unvaccinated, according to an international modelling study. The team used existing data on COVID-19 spread and vaccine effectiveness to create a simulation to test infection rates in different groups; all vaccinated, all unvaccinated and a mix between vaccinated and unvaccinated. Even when modelling for lower vaccine effectiveness and vaccine-resistant variants, the researchers say the infection risk was much higher for vaccinated people when they mingled with unvaccinated people.

Journal/conference: Canadian Medical Association Journal

Link to research (DOI): 10.1503/cmaj.212105

Organisation/s: Dalla Lana School of Public Health, Canada

Funder: This research was supported by a grant from the Canadian Institutes of Health Research (to David Fisman; 2019 COVID-19 rapid researching funding OV4-170360). The funder had no direct role in this work.

Media release

From: Canadian Medical Association Journal

Unvaccinated people increase risk of SARS-CoV-2 for vaccinated people even when vaccination rates are high

Unvaccinated people threaten the safety of the vaccinated even when SARS-Cov-2 vaccination rates are high, according to a new modelling study published in CMAJ (Canadian Medical Association Journal).

"Many opponents of vaccine mandates have framed vaccine adoption as a matter of individual choice," writes Dr. David Fisman, Dalla Lana School of Public Health, University of Toronto, with coauthors. "However, we found that the choices made by people who forgo vaccination contribute disproportionately to risk among those who do get vaccinated."

Researchers used a simple model to explore the effect of mixing between unvaccinated and vaccinated people to understand the dynamics of an infectious disease like SARS-CoV-2. They simulated mixing of like-with-like populations in which people have exclusive contact with others of the same vaccination status as well as random mixing between different groups. When unvaccinated mixed with unvaccinated, the risk to vaccinated people was lower. When vaccinated and unvaccinated people mixed, a substantial number of new infections would occur in vaccinated people, even in scenarios where vaccination rates were high.

The authors' findings remained stable even when they modelled lower levels of vaccine effectiveness for prevention of infection, such as in those who have not received a booster dose or with new SARS-CoV-2 variants. These findings may be relevant to future waves of SARS-CoV-2 or to the behaviour of new variants.

"Risk among unvaccinated people cannot be considered self-regarding," the authors write. In other words, forgoing vaccination can't be considered to affect only the unvaccinated, but also those around them. "Considerations around equity and justice for people who do choose to be vaccinated, as well as those who choose not to be, need to be considered in the formulation of vaccination policy," the authors conclude.

"Impact of population mixing between vaccinated and unvaccinated subpopulations on infectious disease dynamics: implications for SARS-CoV-2 transmission" is published April 25, 2022.

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