AUTHOR=Wu Gonghua , Zhang Wanfang , Wu Wenjing , Wang Pengyu , Huang Zitong , Wu Yueqian , Li Junxi , Zhang Wangjian , Du Zhicheng , Hao Yuantao TITLE=Revisiting the complex time-varying effect of non-pharmaceutical interventions on COVID-19 transmission in the United States JOURNAL=Frontiers in Public Health VOLUME=Volume 12 - 2024 YEAR=2024 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1343950 DOI=10.3389/fpubh.2024.1343950 ISSN=2296-2565 ABSTRACT=effect of NPIs and vaccination on mitigating COVID-19 transmission and identifying important NPIs in the context of different variants pandemic.We found that (i) the empirical reduction in reproduction number attributable to integrated NPIs was 52.0% (95%CI: 44.4%, 58.5%) by August and September 2020, whereas the reduction continuously decreased due to the relaxation of NPIs in following months; (ii) international travel restrictions, stay-at-home requirements, and restrictions on gathering size were important NPIs with the relative contribution higher than 12.5%; (iii) vaccination alone could not mitigate transmission when the fully vaccination coverage was less than 60%, but it could effectively synergize with NPIs; (iv) even with fully vaccination coverage > 60%, combined use of NPIs and vaccination failed to reduce the reproduction number below 1 in many states by February 2022 because of elimination of above NPIs, following with a resurgence of COVID-19 after March 2022.Our results suggest that NPIs and vaccination had a high synergy effect and eliminating NPIs should consider their relative effectiveness, vaccination coverage, and emerging variants.