tetano
Editor, Senior Moderator
Vaccine
. 2026 May 15:85:128687.
doi: 10.1016/j.vaccine.2026.128687. Online ahead of print.
The cost-effectiveness of vaccination against COVID-19 in at-risk populations and older adults in the United Kingdom: Projections using a dynamic transmission model
Michele Kohli[SUP] 1 [/SUP], Michael Maschio[SUP] 2 [/SUP], Amy Lee[SUP] 3 [/SUP], Stephen Kissler[SUP] 4 [/SUP], Stuart Carroll[SUP] 5 [/SUP], Nicholas van de Velde[SUP] 6 [/SUP], Ekkehard Beck[SUP] 7 [/SUP], Orsolya Balogh[SUP] 8 [/SUP], Keya Joshi[SUP] 9 [/SUP]
Affiliations
Objective: This study estimates the potential clinical impact and cost-effectiveness of an Autumn COVID-19 vaccination campaign in the United Kingdom (UK) using a variant-adapted mRNA-1273 vaccine in those aged ≥65 years and those aged 6 months-64 years at high risk (base case population) of severe outcomes, as well as the effect of implementing more restrictive vaccine eligibility requirements.
Methods: A Susceptible-Exposed-Infected-Recovered (SEIR) model was used to predict COVID-19 cases and hospitalisations in the UK. A COVID-19 vaccination and infection consequences decision tree was used to predict health outcomes, costs and quality-adjusted life-year (QALY) losses associated with symptomatic SARS-CoV-2 infections as well as costs and QALY losses associated with COVID-19 vaccination and adverse events over a 1-year time horizon.
Results: Compared to no vaccination, an Autumn mRNA-1273 vaccination campaign is predicted to decrease the number of symptomatic infections from 21.9 million to 20.0 million, and the number of hospitalisations from 150,000 to 116,000. COVID-related deaths and long COVID cases are decreased by 7200 and 18,000, respectively. Costs saved are £467.7 million with 52,000 QALYs gained, resulting in an incremental cost-effectiveness ratio (ICER) of £8963/QALY gained. The ICER was most sensitive to infection incidence, population immunity before the vaccination campaign, vaccine effectiveness against hospitalisation, and hospitalisation probabilities. Narrowing the vaccination eligibility criteria to those aged ≥75 years and those aged 6 months-74 years at high risk of severe outcomes results in fewer outcomes prevented, with 525,300 more symptomatic infections, 6000 more hospitalisations, 1100 additional deaths, and 5200 additional cases of long COVID, compared to the base case. Vaccination of the broader population compared to the narrower population is associated with an ICER of £11,753/QALY gained.
Conclusions: Vaccinating adults aged ≥65 years and high-risk individuals 6 months-64 years remains cost-effective compared both to no vaccination and vaccination of the narrower population.
Keywords: COVID-19; Coronavirus; Cost-effectiveness; SARS-CoV-2; United Kingdom; Vaccination.
. 2026 May 15:85:128687.
doi: 10.1016/j.vaccine.2026.128687. Online ahead of print.
The cost-effectiveness of vaccination against COVID-19 in at-risk populations and older adults in the United Kingdom: Projections using a dynamic transmission model
Michele Kohli[SUP] 1 [/SUP], Michael Maschio[SUP] 2 [/SUP], Amy Lee[SUP] 3 [/SUP], Stephen Kissler[SUP] 4 [/SUP], Stuart Carroll[SUP] 5 [/SUP], Nicholas van de Velde[SUP] 6 [/SUP], Ekkehard Beck[SUP] 7 [/SUP], Orsolya Balogh[SUP] 8 [/SUP], Keya Joshi[SUP] 9 [/SUP]
Affiliations
- PMID: 42140088
- DOI: 10.1016/j.vaccine.2026.128687
Objective: This study estimates the potential clinical impact and cost-effectiveness of an Autumn COVID-19 vaccination campaign in the United Kingdom (UK) using a variant-adapted mRNA-1273 vaccine in those aged ≥65 years and those aged 6 months-64 years at high risk (base case population) of severe outcomes, as well as the effect of implementing more restrictive vaccine eligibility requirements.
Methods: A Susceptible-Exposed-Infected-Recovered (SEIR) model was used to predict COVID-19 cases and hospitalisations in the UK. A COVID-19 vaccination and infection consequences decision tree was used to predict health outcomes, costs and quality-adjusted life-year (QALY) losses associated with symptomatic SARS-CoV-2 infections as well as costs and QALY losses associated with COVID-19 vaccination and adverse events over a 1-year time horizon.
Results: Compared to no vaccination, an Autumn mRNA-1273 vaccination campaign is predicted to decrease the number of symptomatic infections from 21.9 million to 20.0 million, and the number of hospitalisations from 150,000 to 116,000. COVID-related deaths and long COVID cases are decreased by 7200 and 18,000, respectively. Costs saved are £467.7 million with 52,000 QALYs gained, resulting in an incremental cost-effectiveness ratio (ICER) of £8963/QALY gained. The ICER was most sensitive to infection incidence, population immunity before the vaccination campaign, vaccine effectiveness against hospitalisation, and hospitalisation probabilities. Narrowing the vaccination eligibility criteria to those aged ≥75 years and those aged 6 months-74 years at high risk of severe outcomes results in fewer outcomes prevented, with 525,300 more symptomatic infections, 6000 more hospitalisations, 1100 additional deaths, and 5200 additional cases of long COVID, compared to the base case. Vaccination of the broader population compared to the narrower population is associated with an ICER of £11,753/QALY gained.
Conclusions: Vaccinating adults aged ≥65 years and high-risk individuals 6 months-64 years remains cost-effective compared both to no vaccination and vaccination of the narrower population.
Keywords: COVID-19; Coronavirus; Cost-effectiveness; SARS-CoV-2; United Kingdom; Vaccination.