Broad COVID-19 vaccination makes economic sense, especially for older adults, study finds

As the nation gears up for the rollout of an updated COVID-19 vaccine, a new study shows the economic benefits of continued broad vaccination in adults. 

In fact, the country would ultimately save more money that it would spend on vaccinating every person over age 65 with a single dose of an updated mRNA vaccine against coronavirus, the study concludes. 

That’s because of the power of the vaccine to prevent deaths, hospitalizations, short- and long-term illness and lost productivity such as lost workdays in this age group, the researchers report based on a computer model. The model focused on people without immunocompromising conditions or medications.

Meanwhile, in middle-aged adults from 50 to 64 years old, broad vaccination is a good economic investment, the study concludes. Even vaccinating healthy young adults age 18 to 49 would fall within accepted limits for cost-effectiveness under certain conditions. 

The new study, published in JAMA Network Open, comes from a team led by a pair of University of Michigan researchers who have done many vaccine cost-effectiveness studies under contract with the federal Centers for Disease Control and Prevention, or CDC. The paper includes multiple CDC researchers as co-authors.

Lisa Prosser, Ph.D., is the lead author of the new paper and co-leader with David Hutton. Ph.D. of the broader vaccine cost-effectiveness research effort. She is a professor of pediatrics in the U-M Medical School and of health management and policy at the U-M School of Public Health, where Hutton is also a professor. 

“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,” said Prosser. “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.”

She notes that second doses have been recommended for older adults and those of any age with certain conditions for both of the last two COVID-19 vaccination seasons.
The study did not include data from people under the age of 18, because of the lack of data. 

In general, the study finds that broad vaccination could prevent 391 hospitalizations and 43 deaths from severe COVID-19 for every 100,000 people over age 65 vaccinated. For those age 18 to 49, those numbers would be lower, with 39 hospitalizations and 1 death prevented for every 100,000 vaccinated. 

The number of cases of COVID-19, of any severity, that could be prevented through broad vaccination was about the same for all three age groups, between 7,600 and 8,900 for every 100,000 adults vaccinated. 

Prosser notes that declining COVID hospitalization rates may contribute to less favorable economic outcomes in future analyses.

Current COVID-19 situation

CDC data shows that more than 47,000 Americans had COVID-19 listed on their death certificates in 2024, with two-thirds of them having COVID-19 listed as the underlying cause and 34% having it listed as a contributing cause. That is down sharply from the first years of the pandemic, and down substantially from 2023. 

Although the vast majority of U.S. adults have received at least one dose of a COVID-19 vaccine since they became available in early 2021, the percentage receiving the updated vaccine in recent years has dropped markedly.

CDC data show that 28% of adults over age 65 taking part in traditional Medicare had received the 2024-2025 vaccine as of this past February. As of April 2025, 23% of adults of all ages told surveyors they had received the 2024-2025 vaccine. 

Previous research and underlying model

Earlier this year, Prosser and colleagues published a paper in the journal Vaccine evaluating the cost-effectiveness of the national investment in testing, buying and delivering the first vaccines. In all, they show, this national vaccine strategy carried out in 2020 and 2021 more than paid for itself after just one year. 

Even without counting lost productivity, the national COVID-19 vaccine effort saved money for most adult age groups purely by avoiding medical costs, the study concluded. Overall, among all adults over age 40, the nation saved more in avoided medical costs than it spent on the vaccine effort.

The U-M team has presented findings about the cost-effectiveness of several vaccines to meetings of Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practices, which creates recommendations for vaccine use.  

The model used in all of the team’s studies includes everything from the cost of the vaccine itself, to home or lab tests for the virus, to the likelihood of suffering any level of COVD-19 illness or vaccine reaction, to the typical cost of receiving care at any level of illness, to the number of days of work lost for different levels of illness.

The researchers included post-COVID conditions, also called Long COVID or PASC for Post-Acute Sequelae of COVID-19.

The model also incorporates data on actual rates and severity of illness, and death rates, for different age groups.

The model uses conservative estimates, so the size of the savings may actually be even larger than the studies report, Prosser notes. For instance, the model does not include the lost productivity of people who took time off work to care for a sick adult family member, patients’ out-of-pocket costs for treatment, or transportation to get to medical care. 

Prosser notes that the current CDC recommendation is for everyone over the age of 6 months to get at least one dose of the current COVID-19, though the CDC’s recommendation for children without an immune-compromising condition changed this summer to include shared decisionmaking between the child’s parent/guardian and a health care professional. 

For people who are age 65 and older, or immunocompromised because of a health condition or treatment, the CDC recommends a second dose of the current vaccine six months after the first. 

Additional authors: In addition to Prosser and Hutton, the new paper’s authors are Angela M. Rose, M.P.H., Kerra Mercon, M.S., Cara B. Janusz, Ph.D. and Acham Gebremariam, M.S. of U-M’s Susan B. Meister Child Health Evaluation and Research Center; and Megan Wallace, Dr.P.H., Andrew J. Leidner, Ph.D.; Fangjun Zhou, Ph.D.; Ismael R. Ortega-Sanchez, Ph.D.; Danielle Moulia, M.P.H.; Ruth Link-Gelles, Ph.D., M.P.H.; Sharon Saydah, Ph.D., M.H.S.; Melisa Shah, M.D., M.P.H.; and Jamison Pike, Ph.D. from CDC. 

The study was funded by a CDC grant to U-M (75D30122P15319).

Cost-Effectiveness of 2023-2024 COVID-19 Vaccination in US Adults, JAMA Network Open, doi:10.1001/jamanetworkopen.2025.23688