US Vaccine Investment Yields Strong Returns
Full study: The cost-effectiveness of vaccination against COVID-19 illness during the initial year of vaccination (DOI:10.1016/j.vaccine.2025.126725)
Five years ago, volunteers rolled up their sleeves in the first clinical trial of a vaccine against COVID-19, as the new pandemic surged around them. By a year later, 66 million American adults had gotten at least one dose of a COVID-19 vaccine, at no cost to them.
Now, a new study shows how wise that national investment in testing, buying and delivering the first vaccines was.
In all, the national vaccine strategy more than paid for itself after just one year, according to the new findings published in the journal Vaccine by a team led by University of Michigan researchers. Because the vaccines reduced how many adults developed serious illness or died, the United States saved more money than it spent, the study shows.
The analysis includes not only the cost of care for COVID-19 but also the cost of testing and treating people, of treating post-COVID conditions as well as rare vaccine reactions, and productivity costs such as lost workdays when someone became sick or died.
Even without counting lost productivity, the national COVID-19 vaccine effort saved more in avoided medical costs among adults over 40 than it spent on the vaccine effort for this age group.
Among adults aged 18 to 39, who are less likely to get seriously ill from COVID-19, the vaccination effort cost slightly more than the total medical costs avoided, but was still cost-effective by national standards. When lost productivity is included, vaccinating these younger adults was cost-saving.
The U-M team that performed the study has also presented findings about the cost-effectiveness of several vaccines to meetings of Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practices, which creates recommendations for vaccine use.
“All in all, we can safely say that this was a prudent investment for the American people, using a really conservative analysis,” said Lisa Prosser, first author of the new study and professor at the Medical School and School of Public Health. “From a broader societal economic perspective and from the perspective of medical care costs, the federal government’s decision to accelerate vaccine testing, buy large quantities of vaccine, and support the cost of vaccination in many settings was wise.”
Prosser and senior author David Hutton, a professor at the School of Public Health and College of Engineering, worked to develop and test the model, which is based on research findings by many other teams that have studied aspects of COVID-19.
The model includes everything from the cost of the vaccine itself, to home or lab tests for the virus, to the likelihood of suffering any level of COVD-19 illness or vaccine reaction, to the typical cost of receiving care at any level of illness, to the number of days of work lost for different levels of illness.
The researchers included post-COVID conditions-long COVID and PASC for Post-Acute Sequelae of COVID-19.
The model uses conservative estimates, so the size of the savings may actually be even larger than the study reports, Prosser said.
For instance, it does not include the lost productivity of people who took time off work to care for a sick adult family member, patients’ out-of-pocket costs for treatment or transportation to get to medical care. Nor does it include the cost of the basic laboratory science funded by the federal government over two decades that laid the groundwork for the two mRNA vaccines made by Pfizer/BioNTech and Moderna.
Prosser, Hutton and their colleagues have done additional economic modeling of waves of vaccination after 2021 in collaboration with the Centers for Disease Control and Prevention. They hope to create a model for the updated version of the vaccines that are expected to roll out in fall 2025, but it will depend on CDC funding and data.
As for this winter, Prosser said widespread vaccination and improved treatment have decreased the death toll from COVID-19, and the number of cases severe enough to need emergency or hospital care.
Still, between 575 and 1,000 people have died of COVID-19 every week of 2025 for which full data are available as of early April. And about 1% of all emergency department visits in recent months have been for illness diagnosed as COVID-19.
Prosser noted that the current CDC recommendation is for everyone over the age of 6 months to get at least one dose of one of the three updated vaccines that became available in September 2023 and are now updated annually. So far, about 30 million have done so, including about 30% of people aged 65 and older, who are at highest risk of severe COVID-19 if they become infected.
For people who are 65 and older or immunocompromised because of a health condition or treatment, the CDC recommends a second dose of the current vaccine six months after the first.
That means that people who got the updated vaccine soon after it came out in September should now go get a second dose.
Study co-authors: Janamarie Perroud, Grace Chung, Acham Gebremariam, Cara B. Janusz, Kerra Mercon, Angela Rose, Anton Avanceña and Ellen Kim DeLuca. All are or were formerly affiliated with the U-M School of Public Health or the Susan B. Meister Child Health and Evaluation Research Center based in the U-M Medical School’s Department of Pediatrics, which funded the study. Prosser and Hutton are members of the U-M Institute for Healthcare Policy and Innovation.
Written by Kara Gavin, Michigan Medicine, Institute for Healthcare Policy and Innovation
https://news.umich.edu/covid-19-analysis-us-investment-in-vaccine-more-than-paid-off/