The potential clinical impact of implementing different COVID-19 boosters in fall 2022 in the United States

Kohli, Michele; Maschio, Michael; Lee, Amy; Fust, Kelly; Velde, Nicolas Van de; Buck, Philip O.; Weinstein, Milton C.

doi:10.1080/13696998.2022.2126127

Cited by 11 publications

(12 citation statements)

References 11 publications

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“…A previously developed compartmental SEIR model was updated to reflect the clinical and epidemiological situation in the summer of 2023. The model has been previously described in detail; 12 in the updated model with all of the SEIR compartments are stratified by vaccination status as shown in Figure 1. To accommodate changes since the summer of 2022, one more stratum was added to represent the Fall 2023 vaccine.…”

Section: Methodsmentioning

confidence: 99%

“…11 Previously, we published an analysis of the potential clinical impact of the bivalent boosters in the Fall of 2022 in the US using a mathematical model of infection dynamics. 12 We did not conduct an economic assessment, and the incidence of COVID-19 infections has since declined. While the CDC continued to distribute free COVID-19 vaccines in May 2023, the funding of COVID-19 vaccines in the US is transitioning from the pandemic procurement process to the standard processes for childhood and adult vaccines.…”

Section: Introductionmentioning

confidence: 99%

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The potential clinical impact and cost-effectiveness of the updated COVID-19 mRNA Fall 2023 vaccines in the United States

Kohli,

Maschio,

Joshi

et al. 2023

Preprint

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Objectives: To assess the potential clinical impact and cost-effectiveness of COVID-19 mRNA vaccines updated for Fall 2023 in adults ≥18 years over a 1-year analytic time horizon (September 2023-August 2024). Methods: A compartmental Susceptible-Exposed-Infected-Recovered model was updated to reflect COVID-19 in summer 2023. Numbers of symptomatic infections, COVID-19 related hospitalizations and deaths, and costs and quality-adjusted life-years (QALYs) gained were calculated using a decision tree model. The incremental cost-effectiveness ratio (ICER) of a Moderna updated mRNA Fall 2023 vaccine (Moderna Fall Campaign) was compared to no additional vaccination. Potential differences between the Moderna and the Pfizer-BioNTech Fall 2023 vaccines were examined. Results: Base case results suggest the Moderna Fall Campaign would decrease the expected 64.2 million symptomatic infections by 7.2 million (11%) to 57.0 million. COVID-19-related hospitalizations and deaths are expected to decline by 343,000 (-29%) and 50,500 (-33%), respectively. The Moderna Fall Campaign would increase QALYs by 740,880 and healthcare costs by $5.7 billion relative to No Vaccine, yielding an ICER of $7,700 per QALY gained. Using a societal cost perspective, the ICER is $2,100. Sensitivity analyses suggest that vaccine effectiveness, COVID-19 incidence, hospitalization rates and costs drive cost-effectiveness. With a relative vaccine effectiveness (rVE) of Moderna versus Pfizer-BioNTech of 5.1% for infection and 9.8% for hospitalization, use of the Moderna vaccine is expected to prevent 24,000 more hospitalizations and 3,300 more deaths than the Pfizer-BioNTech vaccine. Limitations and Conclusions: As COVID-19 becomes endemic, future incidence, including patterns of infection, are highly uncertain. Vaccine effectiveness of Fall 2023 vaccines is unknown, and it is unclear when a new variant that evades natural or vaccine immunity will emerge. Despite these limitations, the Moderna Fall 2023 vaccine can be considered cost-effective relative to no vaccine.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The potential clinical impact and cost-effectiveness of the updated COVID-19 mRNA Fall 2023 vaccines in the United States

Kohli,

Maschio,

Joshi

et al. 2023

Preprint

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“…Methodology is described in detail in the US cost-effectiveness analysis publication [34], and parameters adapted to France are listed in the Technical Appendix. The resulting projected monthly incidence of symptomatic COVID-19 symptomatic infection among the unvaccinated in France in the model is displayed in Table 2.…”

Section: Incidence Of Symptomatic Infectionmentioning

confidence: 99%

Substantial reduction in the clinical and economic burden of disease following variant-adapted mRNA COVID-19 vaccines in immunocompromised patients in France

Lee,

Davido,

Beck

et al. 2024

Preprint

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An economic evaluation was conducted to predict the economic and clinical burden of vaccinating immunocompromised (IC) individuals aged ≥30 years with mRNA-1273 variant-adapted COVID-19 vaccines in Fall 2023 and Spring 2024 versus BNT162b2 variant-adapted vaccines in France. The number of symptomatic COVID-19 infections, hospitalizations, deaths, and long COVID cases, costs and quality-adjusted life years (QALYs) was estimated using a static decision-analytic model. Predicted vaccine effectiveness (VE) were based on real-world data from prior versions, suggesting higher protection against infection and hospitalization with mRNA-1273 vaccines. VE estimates were combined with COVID-19 incidence and probability of COVID-19 severe outcomes. Uncertainty surrounding VE, vaccine coverage, infection incidence, hospitalization and mortality rates, costs and QALYs were tested in sensitivity analyses. The mRNA-1273 variant-adapted vaccine is predicted to prevent an additional 3,882 infections, 357 hospitalizations, 81 deaths, and 326 long COVID cases when compared to BNT162b2 variant-adapted vaccines in 230,000 IC individuals. This translates to €10.1 million cost-savings from a societal perspective and 645 QALYs saved. Results were consistent across all analyses and most sensitive to variations surrounding VE and coverage. These findings highlight the importance of increasing vaccine coverage, and ability to induce higher levels of protection with mRNA-1273 formulations in this vulnerable population.

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“…A previously developed SEIR model was used to calculate the number of infections (symptomatic and asymptomatic) as well as the VE against hospitalization for this analysis. 22,27 This model has been adapted to Japan and has been used to project incidencefor the analytical time horizon of September 2023 to August 2024. The base case incidence projections and all of the incidence scenario analyses have been previously described.…”

Section: Seir Modelmentioning

confidence: 99%

“…Therefore, the objective of this analysis is to estimate the economic and clinical impact of a NIP vaccination campaign from April 2024 onwards using the Fall 2023 updated mRNA COVID- 19 Moderna vaccine compared to the Fall 2023 updated mRNA COVID-19 Pfizer-BioNTech vaccine for adults 18 years of age and older, using a previously developed Susceptible-Exposed-Infected-Recovered (SEIR) model. 22 The impact of a Spring 2024 vaccination campaign in select, high-risk individuals (60-64 high-risk and 65+ general population; 65+ general population only) is also explored.…”

Section: Introductionmentioning

confidence: 99%

The potential economic impact of the updated COVID-19 mRNA fall 2023 vaccines in Japan

Fust,

Joshi,

Beck

et al. 2023

Preprint

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This analysis estimates the economic and clinical impact of a Moderna updated COVID-19 mRNA Fall 2023 vaccine for adults ≥18 years in Japan. A previously developed Susceptible-Exposed-Infected-Recovered (SEIR) model with a 1-year analytic time horizon (September 2023-August 2024) and consequences decision tree were used to estimate symptomatic infections, COVID-19–related hospitalizations, deaths, quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratio (ICER) for a Moderna updated Fall 2023 vaccine versus no additional vaccination, and versus a Pfizer-BioNTech updated mRNA Fall 2023 vaccine. The Moderna vaccine is predicted to prevent 7.2 million symptomatic infections, 272,100 hospitalizations and 25,600 COVID-19 related deaths versus no vaccine. In the base case (healthcare perspective), the ICER was ¥1,300,000/QALY gained ($9,400 USD/QALY gained). Sensitivity analyses suggest results are most affected by COVID-19 incidence, initial vaccine effectiveness (VE), and VE waning against infection. Assuming the relative VE between both bivalent vaccines apply to updated Fall 2023 vaccines, the base case suggests the Moderna version will prevent an additional 1,100,000 symptomatic infections, 27,100 hospitalizations, and 2,600 deaths compared to the Pfizer-BioNTech vaccine. The updated Moderna vaccine is expected to be highly cost-effective at a ¥5 million willingness-to-pay threshold across a wide range of scenarios.

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The potential clinical impact of implementing different COVID-19 boosters in fall 2022 in the United States

Cited by 11 publications

References 11 publications

The potential clinical impact and cost-effectiveness of the updated COVID-19 mRNA Fall 2023 vaccines in the United States

The potential clinical impact and cost-effectiveness of the updated COVID-19 mRNA Fall 2023 vaccines in the United States

Substantial reduction in the clinical and economic burden of disease following variant-adapted mRNA COVID-19 vaccines in immunocompromised patients in France

The potential economic impact of the updated COVID-19 mRNA fall 2023 vaccines in Japan

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