Abstract
Objective
To assess the cost effectiveness of the second COVID-19 booster vaccination with different age groups.
Methods
We developed a decision-analytic Susceptible-Exposed-Infected-Recovered (SEIR)-Markov model by five age groups (0–4 years, 5–11 years 12–17 years, 18–49 years, and 50+ years) and calibrated the model by actual mortality in each age group in the USA. We conducted five scenarios to evaluate the cost effectiveness of the second booster strategy and incremental benefits if the strategy would expand to 18–49 years and 12–17 years, from a health care system perspective. The analysis was reported according to the Consolidated Health Economic Evaluation Reporting Standards 2022 statement.
Results
Implementing the second booster strategy for those aged ≥ 50 years cost $823 million but reduced direct medical costs by $1166 million, corresponding to a benefit-cost ratio of 1.42. Moreover, the strategy also resulted in a gain of 2596 quality-adjusted life-years (QALYs) during the 180-day evaluation period, indicating it was dominant. Further, vaccinating individuals aged 18–49 years with the second booster would result in an additional gain of $1592 million and 8790 QALYs. Similarly, expanding the vaccination to individuals aged 12–17 years would result in an additional gain of $16 million and 403 QALYs. However, if social interaction between all age groups was severed, vaccination expansion to ages 18–49 and 12–17 years would no longer be dominant but cost effective with an incremental cost-effectiveness ratio (ICER) of $37,572 and $26,705/QALY gained, respectively.
Conclusion
The second booster strategy was likely to be dominant in reducing the disease burden of the COVID-19 pandemic. Expanding the second booster strategy to ages 18–49 and 12–17 years would remain dominant due to their social contacts with the older age group.
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Acknowledgements
This study is supported by the World Health Organization (Grant number: 2022/1262416-0); LZ is supported by the Bill & Melinda Gates Foundation (Grant number: INV-006104); the National Natural Science Foundation of China (Grant number: 81950410639); Outstanding Young Scholars Support Program (Grant number: 3111500001); **’an Jiaotong University Basic Research and Profession Grant (Grant number: xtr022019003, xzy032020032); Epidemiology modelling and risk assessment (Grant number: 20200344) and **’an Jiaotong University Young Scholar Support Grant (Grant number: YX6J004). MS is supported by the National Key R&D Program of China (2022YFC2505100), the National Natural Science Foundation of China (12171387), China Post-doctoral Science Foundation (2018M631134 and 2020T130095ZX), and Young Talent Support Programme of Shaanxi University Association for Science and Technology (20210307).
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All data relevant to the study are included in the Article or in the online appendix.
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The TreeAge programme file used for the analysis described in this manuscript is available from the corresponding author upon reasonable request.
Author contributions
RL, LZ, MS and YL conceived the study. RL was involved in the study concept and design, data acquisition, data analysis, interpretation of data, and drafting of the manuscript. PL and QY were involved in the acquisition of data. CF, JP, WH and GZ were involved in the critical revision of the manuscript. LZ, YL and MS were involved in overall study supervision. RL, LZ, YL and MS had access to and verified the data. All authors participated in preparing the manuscript and have seen and approved the final version for submission.
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Li, R., Lu, P., Fairley, C.K. et al. Cost-Effectiveness of the Second COVID-19 Booster Vaccination in the USA. Appl Health Econ Health Policy 22, 85–95 (2024). https://doi.org/10.1007/s40258-023-00844-2
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DOI: https://doi.org/10.1007/s40258-023-00844-2