Multi-Criteria Decision Analysis to Prioritize People for COVID-19 Vaccination When Vaccines Are in Short Supply

Hend Chaker Masmoudi; Amal Rhili; Imen Zamali; Ahlem Ben Hmid; Melika Ben Ahmed; Myriam Razgallah Khrouf

doi:10.3389/frhs.2022.760626

Multi-Criteria Decision Analysis to Prioritize People for COVID-19 Vaccination When Vaccines Are in Short Supply

Front Health Serv. 2022 Apr 26:2:760626. doi: 10.3389/frhs.2022.760626. eCollection 2022.

Authors

Hend Chaker Masmoudi^{1

2}, Amal Rhili¹, Imen Zamali^{3

4}, Ahlem Ben Hmid^{3

4}, Melika Ben Ahmed^{3

4}, Myriam Razgallah Khrouf^{1

5}

Affiliations

¹ Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia.
² Department of Histology and Cytogenetics, Institute Pasteur of Tunis, Tunis, Tunisia.
³ Department of Clinical Immunology, Pasteur Institute of Tunis, Tunis, Tunisia.
⁴ Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
⁵ Direction de la Pharmacie et du Médicament, Tunis, Tunisia.

Abstract

COVID-19 pandemic underscored the need for a rapid tool supporting decision-makers in prioritizing patients in the immediate and overwhelming context of pandemics, where shortages in different healthcare resources are faced. We have proposed Multi-Criteria Decision Analysis (MCDA) to create a system of criteria and weights to prioritize uses of COVID-19 vaccines in groups of people at significantly higher risk of severe COVID-19 disease or death, when vaccines are in short supply, for use in Tunisia. The prioritization criteria and the levels within each criterion were identified based on available COVID-19 evidence with a focus on the criteria selected by Tunisian scientific committees. To determine the weights for the criteria and levels, reflecting their relative importance, a panel of frontline physicians treating COVID-19 were invited to participate in an online survey using 1,000 minds MCDA software (www.1000minds.com) which implements the PAPRIKA (Potentially All Pairwise RanKings of all possible Alternatives) method. Ten criteria and twenty-three levels have been selected for prioritizing the uses of COVID-19 vaccines in groups of people at significantly higher risk of severe disease or death. Among the invited physicians, sixty have completed the survey. The obtained scores were, in decreasing order of importance (mean weights in parentheses, summing to 100%). Obesity (16.2%), Age (12.7%), Chronic pulmonary diseases (10.8%), Chronic cardiovascular conditions (10.3%), Bone marrow or organ transplantation (10.1%), Immunodeficiency or Immunosuppression (9.6%), Diabetes (9%), Renal failure (8.4%), evolutive cancer (6.9%), and high blood pressure (6%). MCDA-based prioritization scoring system comprising explicit criteria and weights provides an adaptable and multicriteria approach that can assist policy-makers to prioritize uses of COVID-19 vaccines.

Keywords: COVID - 19; MCDA (multi-criteria decision analysis); criteria; prioritization; scoring system; vaccination.