Economic Benefits of Broad COVID-19 Vaccination in US Adults, by Age Group

Broad COVID-19 vaccination proves economically beneficial, especially for older adults, highlighting significant health and financial advantages.

Vaccine and syringe | Image credit: alernon77 - stock.adobe.com

There are substantial economic benefits of broad COVID-19 vaccination in adults, particularly for older populations, according to a new study published in JAMA Network Open, which demonstrated the investment in vaccination can ultimately save more money than it costs.1

The research, a collaborative effort between the University of Michigan (U-M) and the CDC, projects considerable financial savings and improved public health outcomes through the vaccine's capacity to prevent severe illness, hospitalizations, deaths, and lost productivity across various age groups.

“We show that a single dose of 2023-2024 mRNA COVID-19 vaccine averted substantial illness and death across age groups, and that this led to economically attractive results for both of the older age groups across wide variations in the parameters of the model,” Lisa Prosser, PhD, lead author and professor of pediatrics in the U-M Medical School and of health management and policy at the U-M School of Public Health, said in a statement.2 “However, we also find that a second dose in non-immunocompromised adults under age 64 was not economically favorable, though a second dose in adults over age 65 was.”

Cost-Effectiveness Varies by Age Group

The study employed a sophisticated computer model to simulate outcomes for hypothetical cohorts of vaccinated and unvaccinated immunocompetent adults, stratified by age: 18 to 49 years, 50 to 64 years, and 65 years or older. For individuals aged 65 years and older, broad vaccination with a single dose of an updated mRNA vaccine was determined to be cost-saving, indicating that the economic advantages surpassed the expenditures. This demographic showed the most significant impact on severe outcomes, with projections of 391 hospitalizations and 43 deaths averted per 100,000 vaccinated individuals.

Vaccination for middle-aged adults (50-64 years) was identified as a sound economic investment, exhibiting an incremental cost-effectiveness ratio (ICER) of $25,787 per quality-adjusted life-year (QALY) gained. While vaccinating healthy young adults (18-49 years) also provided health benefits, it required a greater investment, with an ICER of $115,588 per QALY gained, which fell within accepted limits for cost-effectiveness only under specific conditions. The study found similar numbers of total COVID-19 cases (any severity) prevented across all adult age groups, ranging from 7600 to 8900 per 100,000 vaccinated individuals.

Single Versus Multiple Doses

A single dose of the 2023-2024 mRNA vaccine was generally economically favorable across all age groups. However, a second dose was only so for adults aged 65 years and older, particularly in higher-risk scenarios. For non-immunocompromised adults under 64 years, a second dose was not economically supported by the model. These findings align with current CDC recommendations.

The current analysis relied only on unpublished data, which was listed as one limitation of the study. In addition, the first phase of this analysis used hospitalization data that did not differentiate between people in the hospital because of COVID-19 and those who had incidental COVID-19 while in the hospital. The study also did not consider the potential impact vaccination has on reducing population transmission, and there are no randomized trials on the subject. However, if broad vaccination reduces transmission, the benefits and the value of vaccination would be even greater, the authors noted.

“…vaccination with an updated 2023 to 2024 COVID-19 mRNA vaccine for all adults in the US may be attractive not only for its expected health gains but also for its economic benefits,” they concluded. “As the evidence base for COVID-19 vaccination and burden of illness rapidly evolve, it will be important to continue to update and revise the economic evaluation of vaccination against COVID-19.”

References

1. Prosser LA, Wallace M, Rose AM, et al. Cost-effectiveness of 2023-2024 COVID-19 vaccination in US adults. JAMA Netw Open. 2025;8(8):e2523688. doi:10.1001/jamanetworkopen.2025.23688

2. Broad COVID-19 vaccination makes economic sense, especially for older adults, study finds. News release. University of Michigan. August 14, 2025. Accessed August 15, 2025. https://www.newswise.com/articles/broad-covid-19-vaccination-makes-economic-sense-especially-for-older-adults-study-finds