Leaky protection reveals three patterns in the relative advantages of vaccination strategies across transmission intensity
Abstract
Targeted vaccination often prioritizes individuals who contribute most to transmission. However, this rationale may change under leaky protection, whereby vaccination reduces susceptibility at each exposure rather than fully preventing infection. Here, we use a survey-derived individual-level exposure framework for 2,279 residents to simulate infection dynamics across ranges of transmission intensity and vaccine efficacy. We compare two vaccination strategies: the high-exposure strategy (prioritizing highly exposed individuals) and the oldest-first strategy (prioritizing older individuals). As transmission intensity changes, we identify three patterns in the relative advantages of these two strategies. At low transmission, the high-exposure strategy outperforms the oldest-first strategy in reducing both epidemic peak size and final infection proportion. At intermediate transmission, it lowers epidemic peak size but increases final infection proportion, revealing a trade-off between these metrics. At high transmission, differences between the strategies narrow, and the oldest-first strategy has a slight advantage for both metrics. Overall, our findings highlight the importance of considering vaccine failure mode when evaluating vaccination policies under different transmission dynamics.
Related
- Rational mRNA Structure -guided Attenuation Enables Embryo-safe in-ovo NDV Vaccination and Protection
- Comparison of Methods for Assessing Chlamydia trachomatis Transmission Intensity: A Systematic Review
- CD8+ stem cell-like memory T cells: Unveiling the potential for next-generation vaccination strategies
- Design of a comprehensive protection algorithm for fault detection, classification, and location in high voltage direct current transmission lines connected to wind farms based on local terminal measurements
- Mathematical modeling of HBV–HDV transmission with superinfection: The role of vaccination and liver transplantation in disease dynamics
BibTeX
@misc{xing2026leaky,
title = {{Leaky protection reveals three patterns in the relative advantages of vaccination strategies across transmission intensity}},
author = {Yiwen Xing and Jianyi Zhang and Haoliang Cui and Zijie Yang and Qianning Wang and Lang Qin and Zheqi Wang and Zhongwei Jia},
howpublished = {arXiv},
year = {2026},
month = oct,
doi = {10.48550/arxiv.2610.13567},
eprint = {2610.13567},
archivePrefix = {arXiv},
url = {https://arxiv.org/abs/2610.13567},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Leaky protection reveals three patterns in the relative advantages of vaccination strategies across transmission intensity
AU - Yiwen Xing
AU - Jianyi Zhang
AU - Haoliang Cui
AU - Zijie Yang
AU - Qianning Wang
AU - Lang Qin
AU - Zheqi Wang
AU - Zhongwei Jia
PY - 2026
DA - 2026/10/09
PB - arXiv
DO - 10.48550/arxiv.2610.13567
UR - https://arxiv.org/abs/2610.13567
AB - Targeted vaccination often prioritizes individuals who contribute most to transmission. However, this rationale may change under leaky protection, whereby vaccination reduces susceptibility at each exposure rather than fully preventing infection. Here, we use a survey-derived individual-level exposure framework for 2,279 residents to simulate infection dynamics across ranges of transmission intensity and vaccine efficacy. We compare two vaccination strategies: the high-exposure strategy (prioritizing highly exposed individuals) and the oldest-first strategy (prioritizing older individuals). As transmission intensity changes, we identify three patterns in the relative advantages of these two strategies. At low transmission, the high-exposure strategy outperforms the oldest-first strategy in reducing both epidemic peak size and final infection proportion. At intermediate transmission, it lowers epidemic peak size but increases final infection proportion, revealing a trade-off between these metrics. At high transmission, differences between the strategies narrow, and the oldest-first strategy has a slight advantage for both metrics. Overall, our findings highlight the importance of considering vaccine failure mode when evaluating vaccination policies under different transmission dynamics.
ER -