Economic Evaluation of COVID-19 Vaccination Programs

The economic appraisal of COVID-19 vaccination programmes encompasses a range of methodological approaches designed to quantify both the costs and benefits of immunisation at national and global levels. Core analyses employ decision-analytic and dynamic transmission models to estimate direct medical costs averted, productivity losses prevented and broader societal gains. Key outcomes include quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs) saved, incremental cost-effectiveness ratios (ICERs) and benefit–cost ratios under varying scenarios of vaccine efficacy, coverage and timing. Evaluations address heterogeneity in age, risk profile and regional healthcare capacity, and they compare roll-out strategies—from prioritising high-risk groups under constrained supply to mass vaccination as availability increases. Economic assessments also consider equity in global distribution, highlighting how supply chains and international collaboration can amplify welfare gains. Overarching findings reveal that early, rapid, and equitable deployment of vaccines not only curtails morbidity and mortality but also delivers substantial net economic benefits, reinforcing the importance of continued investment in procurement, distribution infrastructure and preparedness for future pandemics.

Research from Nature Portfolio

Recent studies have shown that optimising global vaccine supply chains produces significant macro-economic benefits. One analysis using idealised distribution scenarios found that equitable allocation across countries could boost global economic output by nearly 12 per cent, equivalent to hundreds of billions of dollars annually, while prioritisation of high-risk elderly and frontline workers in low-income settings yielded measurable gains in gross domestic product. Another investigation applied a microsimulation model to a middle-income country, demonstrating that reaching at least 40 per cent population coverage prevented over nine million infections and more than seventy thousand deaths, and reduced healthcare expenditure sufficiently to offset vaccination costs. Both studies underscore how prompt procurement, strategic rollout and supply-chain resilience are critical drivers of both health and economic efficiency in vaccination programmes.

Economic Evaluation of COVID-19 Vaccination Programs publication trend

The graph below shows the total number of articles in economic evaluation of covid-19 vaccination programs across all publications each year (not limited to Nature Index journals).

Technical terms

Incremental cost-effectiveness ratio (ICER): The additional cost per additional unit of health gain, such as cost per QALY gained, comparing vaccination to no vaccination or alternative strategies.

Quality-adjusted life year (QALY): A composite measure combining length and quality of life, used to quantify health outcomes and inform value-for-money assessments.

Disability-adjusted life year (DALY): A metric representing years of healthy life lost due to illness or premature death, used to gauge disease burden.

Dynamic transmission model: A mathematical framework that simulates how infectious diseases spread over time and across populations, capturing indirect effects of vaccination through herd immunity.

Microsimulation model: A simulation approach that tracks individual health trajectories and costs to estimate aggregate programme outcomes under varying scenarios.

References

1. Supply chains create global benefits from improved vaccine accessibility. Nature Communications (2023).
2. COVID-19 Vaccination Scenarios: A Cost-Effectiveness Analysis for Turkey. Vaccines (2021).
3. The potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine: a modelling study. EClinicalMedicine (2024).
4. Assessing the impacts of COVID-19 vaccination programme’s timing and speed on health benefits, cost-effectiveness, and relative affordability in 27 African countries. BMC Medicine (2023).
5. Economic evaluation of COVID-19 vaccination: A systematic review. Journal of Global Health (2023).