As the global community continues to adapt to the evolving challenges of the COVID-19 pandemic, a newly published study in JAMA Network Open sheds light on the economic viability and extensive public health benefits of administering updated mRNA COVID-19 vaccines broadly across adult populations in the United States. This latest research provides a comprehensive cost-effectiveness analysis, employing sophisticated computer modeling to quantify not only the health outcomes but also the economic impact of vaccination strategies targeted at diverse adult age groups in the 2023-2024 vaccination season.
The investigators, led by University of Michigan researchers Lisa Prosser, Ph.D., and David Hutton, Ph.D., have meticulously developed a model that integrates a multitude of parameters including vaccination costs, healthcare utilization, illness severity, and productivity losses related to COVID-19. Their work underscores a critical finding: vaccination of all adults over the age of 65 with a single updated mRNA dose is not merely cost-effective but ultimately cost-saving. The model demonstrates that healthcare expenses averted through prevented hospitalizations, severe illnesses, and deaths surpass the total investment in vaccine procurement and administration within this demographic.
One of the central tenets of the study involves the nuanced assessment of vaccine doses administered. While a single dose in older adults yields substantial economic and health benefits, the addition of a second dose in adults under age 64 who are not immunocompromised does not meet the threshold for economic favorability in this model. Conversely, the research supports the CDC’s current recommendation of second doses for adults over 65 and those with immunocompromising conditions, reflecting that such booster administration remains a cost-effective intervention in these higher-risk groups.
The study’s projections are anchored on large-scale datasets detailing rates of COVID-19 infection, hospitalization, and mortality stratified by age, carefully excluding individuals with immunocompromising conditions or on immunosuppressive treatments to focus on the typical adult population that vaccines target. This granular approach helps refine estimates of vaccine impact, with the model predicting prevention of approximately 391 hospitalizations and 43 deaths per 100,000 vaccinated individuals over 65, compared to 39 hospitalizations and a single death prevented per 100,000 vaccinated people aged 18 to 49. These statistics not only reflect the direct medical benefits but also the substantial alleviation of prolonged and severe disease burdens that strain healthcare systems.
A salient feature of the research is its incorporation of the economic ramifications beyond direct medical costs. The investigators considered lost productivity from absenteeism due to illness and long-term consequences of COVID-19, including Post-Acute Sequelae of SARS-CoV-2 infection (PASC), widely known as Long COVID. Accounting for these factors reinforces the argument that broad vaccination generates savings extending well into societal and economic domains, emphasizing that prevention transcends immediate clinical considerations.
Despite encouraging data, the study also acknowledges evolving dynamics, such as the recent decline in COVID-19 hospitalization rates, which could diminish the economic benefits of vaccination as the pandemic progresses. Prosser notes that this trend necessitates ongoing evaluation to tailor vaccination policies dynamically in response to shifting epidemiological landscapes, ensuring that resource allocations remain justified both from health and economic perspectives.
The vaccination uptake data presented reveal concerning trends that complicate public health efforts. While over 80% of adults have received at least one dose of a COVID-19 vaccine since rollout began in early 2021, recent figures show a marked reduction in uptake of the updated 2024-2025 vaccine. As of February 2025, only 28% of adults over 65 enrolled in traditional Medicare had received the newer vaccine, and by April of the same year, just 23% of surveyed adults reported obtaining it. This hesitancy or reduced demand for booster doses poses challenges to achieving population-level immunity and maximizing the benefits detailed in the study.
Delving into the methodological sophistication, the model employed delineates comprehensive cost inputs extending beyond the price of vaccines to include laboratory testing, emergency visits, hospital stays, and outpatient care costs corresponding to COVID-19 severity levels. It further estimates workdays lost across illness spectrums and integrates vaccine side-effect probabilities. Notably, the model adopts conservative assumptions, which implies that actual cost savings from vaccination campaigns may exceed those projected. The omission of indirect costs such as caregiver productivity loss and patient out-of-pocket expenses signals potential underestimation of the true economic value of vaccines.
This analysis builds upon earlier work by the same research team, which demonstrated that the U.S. national investment in COVID-19 vaccine development, manufacturing, and deployment in 2020-2021 recouped its costs within a year, by averting overwhelming medical expenses and mitigating disease impact. The current findings reaffirm and extend this evidence with an updated focus on booster dose cost-effectiveness and age-stratified recommendations, providing robust data for policymakers and public health officials tasked with optimizing vaccine distribution strategies.
Public health authorities, including the CDC’s Advisory Committee on Immunization Practices (ACIP), have historically relied on such evidence-based cost-effectiveness analyses to formulate vaccination guidelines. The University of Michigan team’s rigorous research contributes directly to this decision-making process, offering precise economic evaluations that consider a broad spectrum of variables and real-world outcomes, thus supporting nuanced recommendations tailored to age and health status.
While the study omits pediatric populations due to limited data, CDC guidelines continue to advocate for vaccination starting from 6 months of age, emphasizing the importance of shared decision-making for otherwise healthy children. For adults, the study’s data support the strategic prioritization of booster doses in higher-risk groups, reinforcing the role of vaccination as a cornerstone in limiting COVID-19 morbidity and mortality.
In the face of continued viral evolution and periodic surges, this study underscores the imperative of maintaining robust vaccination programs. Its conclusions suggest that well-targeted booster campaigns among older adults not only save lives but are financially prudent at a population level. Moreover, the research indicates potential cost-effectiveness even in younger demographics under certain conditions, highlighting opportunities for nuanced public health strategies.
As vaccination strategies evolve, ongoing surveillance and updated economic modeling will be essential to ensure optimal allocation of resources. The findings presented by Prosser, Hutton, and their collaborators equip stakeholders with the quantitative tools necessary to navigate complex trade-offs inherent in managing an endemic viral threat. This study thereby represents a critical advancement in our understanding of how investment in vaccine coverage translates into measurable health and economic dividends, reinforcing the role of vaccination as a pivotal intervention in pandemic response.
Subject of Research: People
Article Title: Cost-Effectiveness of 2023-2024 COVID-19 Vaccination in US Adults
News Publication Date: 7-Aug-2025
Web References:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2837339
References:
Prosser L.A., Hutton D.W., et al. (2025). Cost-Effectiveness of 2023-2024 COVID-19 Vaccination in US Adults. JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.23688
Keywords: COVID 19 vaccines, mRNA vaccines, Preventive medicine, Vaccination, Medical economics, Health care costs, Cost effectiveness
