Cost-effectiveness of Coronavirus Disease 2019 Vaccination in Low- and Middle-Income Countries

Abstract

Background Despite the advent of safe and effective COVID-19 vaccines, pervasive inequities in global vaccination persist. Methods We projected health benefits and donor costs of delivering vaccines for up to 60% of the population in 91 low- and middle-income countries (LMICs). We modeled a highly contagious (Re at model start = 1.7), low-virulence (IFR = 0.32%) “omicron-like” variant and a similarly contagious “severe” variant (IFR = 0.59%) over 360 days, accounting for country-specific age structure and healthcare capacity. Costs included vaccination startup (US$630 million) and per-person procurement and delivery (US$12.46/person vaccinated). Results In the omicron-like scenario, increasing current vaccination coverage to achieve at least 15% in each of the 91 LMICs would prevent 11 million new infections and 120,000 deaths, at a cost of US$0.95 billion, for an incremental cost-effectiveness ratio (ICER) of US$670/year-of-life saved (YLS). Increases in vaccination coverage to 60% would additionally prevent up to 68 million infections and 160,000 deaths, with ICERs < US$8,000/YLS. ICERs were < US$4,000/YLS under the more severe variant scenario and generally robust to assumptions about vaccine effectiveness, uptake, and costs. Conclusions Funding expanded COVID-19 vaccine delivery in LMICs would save hundreds of thousands of lives, be similarly or more cost-effective than other donor-funded global aid programs, and improve health equity.

Perceived health literacy and COVID-19 vaccine acceptance among Chinese college students: A mediation analysis

“…of the population expressed COVID-19 vaccine hesitancy [23,24]. Since COVID-19 vaccination is a significant cost-effective intervention, improving the global COVID-19 vaccine acceptance is critical to the management of COVID-19 [25].…”

Economic evaluation of COVID-19 vaccination: A systematic review

“…The two remaining studies were conducted in multiple countries; the first one comprised four analyses from LMICs and two analyses from HICs [ 36 ], while the other study comprised 12 analyses in LMICs [ 42 ]. Sixteen studies were conducted in 2021 [ 21 - 28 , 30 - 33 , 35 - 37 , 41 ], while nine studies were conducted in 2022 [ 29 , 34 , 38 - 40 , 42 - 45 ]. Most of the included studies (21/25) aimed to estimating the economic evaluation of different vaccination strategies [ 21 - 30 , 32 , 33 , 35 - 38 , 40 , 42 - 45 ], while two studies were conducted with the goal of estimating the economic evaluation of vaccination vs no vaccination [ 34 , 41 ].…”

“…Sixteen studies were conducted in 2021 [ 21 - 28 , 30 - 33 , 35 - 37 , 41 ], while nine studies were conducted in 2022 [ 29 , 34 , 38 - 40 , 42 - 45 ]. Most of the included studies (21/25) aimed to estimating the economic evaluation of different vaccination strategies [ 21 - 30 , 32 , 33 , 35 - 38 , 40 , 42 - 45 ], while two studies were conducted with the goal of estimating the economic evaluation of vaccination vs no vaccination [ 34 , 41 ]. Only one study assessed the economic impact of booster vaccination [ 31 ], while another compared the intradermal vaccine with the intramuscular vaccine [ 39 ].…”

Optimal selection of COVID-19 vaccination sites in the Philippines at the municipal level

“…This study does not consider other costs associated to vaccine delivery such as cold chain storage, waste management, transportation expenses, and technical assistance. Other factors which are not included in the costs can be due to coordination and planning, social mobilization, training of personnel, physician’s fee, and other miscellaneous costs ( Siedner et al, 2022 ). We recognize that although these factors are important, these costs can be assumed to be the same for all the vaccination sites since the study is done at the municipal level.…”