Cost-Effectiveness Analysis of COVID-19 Vaccine Booster Dose in the Thai Setting during the Period of Omicron Variant Predominance

Abstract

The Thai government implemented COVID-19 booster vaccines to prevent morbidity and mortality during the spreading of the Omicron variant. However, little is known about which types of vaccine should be invested in as the booster dose for the Thai population. This study aims to investigate the most cost-effective COVID-19 vaccine for a booster shot as empirical evidence for Thai policymakers. This study applied a stochastic simulation based on a compartmental susceptible-exposed-infectious-recovered model and included system dynamics in the model. We evaluated three scenarios: (1) No booster, (2) A viral vector vaccine as the booster dose, (3) An mRNA vaccine as the booster dose. The incremental cost-effectiveness ratio (ICER) was calculated based on provider perspectives. We found the number of cases in scenarios with viral vector and mRNA booster doses to be lower than in the non-booster group. Likewise, the number of deaths in the viral vector and the mRNA booster scenarios was threefold lower than in the no-booster scenario. Moreover, the estimated grand cost for the no-booster scenario was over 100 billion baht, while viral vector and mRNA scenario costs were 70 and 64.7 billion baht, respectively. ICER shows that viral vector and mRNA scenarios are more cost-effective than the no-booster scenario. Viral vector booster shot appeared to be slightly more cost-effective than mRNA booster shot in terms of death aversion. However, being boosted by an mRNA vaccine seemed slightly more cost-effective than a viral vector vaccine concerning case aversion. In conclusion, policies to promote COVID-19 booster shots in the Thai population by either mRNA or viral vector vaccines are likely to be worthwhile for both economic and public health reasons.

Cost-effectiveness analysis of COVID-19 booster doses and oral antivirals in the Indo-Pacific

“…A recent systematic review on the cost-effectiveness of COVID-19 vaccines noted a gap in published literature on the cost-effectiveness of booster doses [58] (June 2023). Our results align with available studies which demonstrate that booster doses appear cost saving in middle and high-income settings [59][60][61]. Previous studies have demonstrated that providing nirmatrelvir-ritonavir to high-risk adults would be cost-effective in high-income settings [36,62,63].…”

“…Our results are comparable to similar studies, although there have been a limited number of studies published on the cost-effectiveness of oral antivirals or booster doses in low-and [59][60][61]. Previous studies have demonstrated that providing nirmatrelvir-ritonavir to high-risk adults would be cost-effective in high-income settings [36,62,63].…”

A two-arm analysis of the immune response to heterologous boosting of inactivated SARS-CoV-2 vaccines

“…Further follow up studies are required to determine if this enhanced immunity results in more protection against SARS-CoV-2 infection and prevents development of severe disease. This will be important to evaluate the cost effectiveness of continued booster programs for the general population using either mRNA- or viral vector vaccines 37 . SARS-CoV-2 infection is more problematic in people with chronic underlying conditions, including the elderly as well as immunocompromised individuals 38 who are at high risk of developing severe disease from SARS-CoV-2 and should receive a regular boosting dose to maximize protection 39 , 40 .…”

Vaccine hesitancy in patients with COVID-19 who have back pain

“…In addition, the quality of life of individuals with back pain caused by COVID-19 is diminished [ 15 ]. Therefore, vaccination, which is a much cheaper and more protective method [ 16 ], substantially increases the likelihood that infected individuals will have mild COVID-19 [ 17 ] and reduces treatment costs [ 18 ]. Health systems are currently experiencing problems in terms of financing resources, and waiting times for treatment have increased in many countries, especially due to the inadequacy of unaffordable health systems.…”

“…The quality of life of those who experience back pain due to COVID-19 is diminished [ 15 ], and serious costs would be incurred to restore their quality of life. The motivation of this study was to draw attention to back pain as a symptom of COVID-19 in the context of vaccination, which is known to be very simple and cost-effective [ 16 , 18 , 22 , 23 ]. Specifically, this study investigated vaccine hesitancy and associated factors in patients with back pain who had PCR-confirmed COVID-19 tested and were hospitalized in a COVID-19 ward.…”