Benefit of COVID-19 Vaccination Accounting for Potential Risk Compensation

Newly developed vaccines have tremendous potential in the fight against the COVID-19 pandemic. Risk compensation is the phenomenon where people receiving vaccines or other preventive measures may subsequently increase their previously suppressed exposure risk. Here a parsimonious mathematical model is presented that aims to evaluate the benefit of vaccination to the vaccinated (index) person and others exposed to that person; and calculate the amount of risk compensation required to eliminate all the benefit or to halve the benefit. As shown, 2.5-fold increase in exposure may eliminate the benefit of a vaccine of moderate efficacy (E=0.6) unless the probability of infection in the population of interest is very high. With very high vaccine efficacy (E=0.95), substantial benefit is maintained except in situations where there is very low probability of infection in the population. If the vaccine efficacy decreases to 0.8, the benefit may get eroded easily with modest risk compensation. Risk compensation may markedly affect the benefit of COVID-19 vaccination, especially if vaccine efficacy in real-life or specific high-risk populations (e.g. nursing home residents) is not very high