Lower dosing of COVID-19 vaccine could save lives in a supply shortage

Editor's Note

A study, titled “Modeling comparative cost-effectiveness of SARS-CoV-2 vaccine dose fractionation in India” and published in February 2022 by Nature Media, found that administering smaller doses of the COVID-19 vaccines may be an economically viable way to save more lives than either fully vaccinating or not vaccinating in low- and middle-income countries, JAMA Network April 19 reports.

The study assumes a vaccine supply shortage, which are more likely to occur in low- and middle-income countries. As of January 2022, the vaccination rate was 11% for low-income countries and 47% for middle-income countries, JAMA reports. The cited study “estimated the costs of hospitalization and vaccination and the economic benefits of averting COVID-19 deaths…if lower doses were administered in India.”

The study found that one eighth (1/8) of a regular dose is the “optimal strategy regardless of transmission rate,” and that this fractioning could save an estimated 4 million “life-years” during “high community transmission” and an estimated 11.34 million life-years during low transmission periods. In short, fractional-dosing could mitigate the “public health and economic burdens of vaccine shortages,” hospitalizations, and deaths.

While fractional doses have already been used in young children and in booster doses, fully adopting such a strategy would depend on many factors and need further clinical, policy, and operational research, the study concluded.