Evaluating COVID-19 control measures in mass gathering events with vaccine inequalities.

With the increasing global adoption of COVID-19 vaccines, limitations on mass gathering events have started to gradually loosen. However, the large vaccine inequality recorded among different countries is an important aspect that policymakers must address when implementing control measures for such events. In this paper, we propose a model for the assessment of different control measures with the consideration of vaccine inequality in the population. Two control measures are considered: selecting participants based on vaccine efficacy and restricting the event capacity. We build the model using agent-based modeling to capture the spatiotemporal crowd dynamics and utilize a genetic algorithm to assess the control strategies. This assessment is based on factors that are important for policymakers such as disease prevalence, vaccine diversity, and event capacity. A quantitative evaluation of vaccine diversity using the Simpson's Diversity Index is also provided. The Hajj ritual is used as a case study. We show that strategies that prioritized lowering the prevalence resulted in low event capacity but facilitated vaccine diversity. Moreover, strategies that prioritized diversity resulted in high infection rates. However, increasing the prioritization of participants with high vaccine efficacy significantly decreased the disease prevalence. Strategies that prioritized ritual capacity did not show clear trends.