Fig. 1: Projected COVID-19 dynamics given vaccine hesitancy.

Panels a, b show a high vaccine efficacy (94% against infection, 98% against hospitalisation and death), panels c, d moderate vaccine efficacy (63% against infection, 85% against hospitalisation and death). Panels a and c show the reproductive number Rt profile, which represents the level of NPI stringency, with lower numbers indicating higher stringency. In this illustrative example, we assume that a first wave of transmission occurred at the beginning of 2020 with the assumed value of Ro: 3. This was followed by NPIs leading to a reduction in Rt to 1, followed by an Rt of 1.5 as NPIs are lifted leading to a second wave of transmission in the latter half of 2020. After vaccination is introduced at the beginning of 2021, NPIs in all scenarios are lifted according to a schedule based on coverage under the ideal scenario (no vaccine hesitancy, 95% of individuals 15 years plus are vaccinated). Panels b and d show projected deaths per million under vaccine hesitancy scenarios: adults-only vaccination (orange), vaccination including children (purple). Continuous lines represent simulations of median vaccine coverage per age group, while dashed lines represent simulation of 10% and 90% quantiles. For the ideal scenario black line represents adults-only vaccination and green line represents ideal scenario when children vaccination is considered. In each scenario, final vaccination coverage per age group and deaths vary according to vaccine hesitancy. Vertical dashed lines indicate the vaccination rollout period in the ideal scenario.