Clinical Impact and Cost-Effectiveness of Updated 2023/24 COVID-19 mRNA Vaccination in High-Risk Populations in the United States

Abstract Introduction In the post-pandemic era, people with underlying medical conditions continue to be at increased risk for severe COVID-19 disease, yet COVID-19 vaccination uptake remains low. This study estimated the clinical and economic impact of updated 2023/24 Moderna COVID-19 vaccination a...

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Main Authors: Keya Joshi, Mariia Dronova, Ewelina Paterak, Van H. Nguyen, Hagit Kopel, James Mansi, Nicolas Van de Velde, Ekkehard Beck
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-04-01
Series:Infectious Diseases and Therapy
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Online Access:https://doi.org/10.1007/s40121-025-01128-z
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Summary:Abstract Introduction In the post-pandemic era, people with underlying medical conditions continue to be at increased risk for severe COVID-19 disease, yet COVID-19 vaccination uptake remains low. This study estimated the clinical and economic impact of updated 2023/24 Moderna COVID-19 vaccination among high-risk adults versus no 2023/24 vaccination and versus updated Pfizer/BioNTech vaccination. Methods A static Markov model was adapted for high-risk adults, including immunocompromised (IC), chronic lung disease (CLD), chronic kidney disease (CKD), cardiovascular disease (CVD), and diabetes mellitus (DM) populations in the United States (US). Results Vaccination with the updated Moderna vaccine at current coverage rates was estimated to prevent considerable COVID-19 hospitalizations in CLD (101,309), DM (97,358), CVD (47,830), IC (14,834), and CKD (13,558) populations versus no 2023/24 vaccination. Vaccination also provided net medical cost-savings of US$399 million (M)–2129M (healthcare payer) and $457M–2531M (societal perspective), depending on population. The return-on-investment was positive across all conditions ($1.10–$2.60 gain for every $1 invested). Healthcare savings increased with a relative 10% increase in current vaccination coverage ($439M–$2342M), and from meeting US 2030 targets of 70% coverage ($1096M–$5707M). Based on higher vaccine effectiveness observed in real-world evidence studies, updated Moderna vaccination was estimated to prevent additional COVID-19 hospitalizations in DM (13,105), CLD (10,359), CVD (6241), IC (1979), and CKD (942) versus Pfizer/BioNTech’s updated vaccine, with healthcare payer and societal cost-savings, making it the dominant strategy. Healthcare savings per patient vaccinated with Moderna versus Pfizer/BioNTech’s updated vaccine were $31.00–$59.00, depending on population. Results were robust across sensitivity/scenario analyses. Conclusions Updated 2023/24 Moderna COVID-19 vaccination was estimated to provide significant health benefits through prevention of COVID-19 in high-risk populations, and cost-savings to healthcare payers and society, versus no 2023/24 vaccination and updated Pfizer/BioNTech vaccination. Increasing current low COVID-19 vaccination coverage rates was estimated to be cost-saving while preventing many more severe infections and hospitalizations in these high-risk populations. A graphical abstract is available with this article. Graphical Abstract
ISSN:2193-8229
2193-6382