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J Med Econ . Annual vaccination with BNT162b2 in Germany can avoid substantial clinical and economic burden of COVID-19 disease

tetano

Editor, Senior Moderator
J Med Econ


. 2026 Dec;29(1):16-28.
doi: 10.1080/13696998.2025.2604970. Epub 2025 Dec 27. Annual vaccination with BNT162b2 in Germany can avoid substantial clinical and economic burden of COVID-19 disease

Amy Barber[SUP] 1 [/SUP], Julie Roiz[SUP] 1 [/SUP], Sam Greenall[SUP] 1 [/SUP], Edward Church[SUP] 1 [/SUP], Andrea Schmetz[SUP] 2 [/SUP], Stefan Riebel[SUP] 2 [/SUP], Jingyan Yang[SUP] 3 [/SUP], Oliver Witzke[SUP] 4 [/SUP], Afschin Gandjour[SUP] 5 [/SUP]



Affiliations
Free article Abstract

Aims: To quantify the clinical and economic burden of Coronavirus disease 19 (COVID-19), and burden potentially avoided with annual vaccination, in German adults in an endemic setting.
Materials and methods: A decision tree model was constructed to estimate the clinical and economic impact of COVID-19 and projected burden avoided with BNT162b2, a seasonally adapted mRNA vaccine against severe COVID-19 disease. The majority of cost inputs and clinical event probabilities were informed by German real-world evidence from seasons 2022/23 and 2023/24. Vaccine efficacy was derived from US and German studies. Long/Post COVID impact was assessed in scenario analysis.
Results: The model estimated up to 20.8 million symptomatic infections per year in adults, including 7.5 million in people aged 60+, and 6.0 million in comorbid adults. This translates to an estimated 198,598 hospitalizations and 24,626 COVID-attributable deaths, with 93.6% of deaths occurring in people aged 60+. The total economic burden including productivity loss was estimated at €1.4 billion in people aged 60+, €2.0 billion in comorbid adults, and €3.9 billion in all working adults. Long/Post COVID increased the economic burden by 1.7 times.
Assuming vaccination of 100% of recommended groups, 11.0 million symptomatic infections could be prevented, with the greatest impact in people aged 60+ (estimated 110,362 hospitalizations and 13,685 deaths avoided). For people aged 60+, comorbid adults, and all working adults, the number needed to vaccinate to prevent one symptomatic infection was 7, 4, and 4 people; to prevent one hospitalization, 231, 2,363, and 4,549; and to avoid one death, 1,862, 19,055, and 36,683, respectively.
Conclusion: COVID-19 imposes a substantial clinical and economic burden on the German population, which could be mitigated with an expanded COVID-19 vaccination program. Further research into Long/Post COVID is needed. Our study presents considerations highlighting the value of broad vaccination especially for working adults.

Keywords: BNT162b2; COVID-19; Germany; H00; I10; I18; Omicron; burden of disease; economic burden of disease; vaccination.

 
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