Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, Connecticut.
Agent-Based Modelling Laboratory, York University, Toronto, Ontario, Canada.
JAMA Netw Open. 2022 Nov 1;5(11):e2243127. doi: 10.1001/jamanetworkopen.2022.43127.
New York City, an early epicenter of the pandemic, invested heavily in its COVID-19 vaccination campaign to mitigate the burden of disease outbreaks. Understanding the return on investment (ROI) of this campaign would provide insights into vaccination programs to curb future COVID-19 outbreaks.
To estimate the ROI of the New York City COVID-19 vaccination campaign by estimating the tangible direct and indirect costs from a societal perspective.
DESIGN, SETTING, AND PARTICIPANTS: This decision analytical model of disease transmission was calibrated to confirmed and probable cases of COVID-19 in New York City between December 14, 2020, and January 31, 2022. This simulation model was validated with observed patterns of reported hospitalizations and deaths during the same period.
An agent-based counterfactual scenario without vaccination was simulated using the calibrated model.
Costs of health care and deaths were estimated in the actual pandemic trajectory with vaccination and in the counterfactual scenario without vaccination. The savings achieved by vaccination, which were associated with fewer outpatient visits, emergency department visits, emergency medical services, hospitalizations, and intensive care unit admissions, were also estimated. The value of a statistical life (VSL) lost due to COVID-19 death and the productivity loss from illness were accounted for in calculating the ROI.
During the study period, the vaccination campaign averted an estimated $27.96 (95% credible interval [CrI], $26.19-$29.84) billion in health care expenditures and 315 724 (95% CrI, 292 143-340 420) potential years of life lost, averting VSL loss of $26.27 (95% CrI, $24.39-$28.21) billion. The estimated net savings attributable to vaccination were $51.77 (95% CrI, $48.50-$55.85) billion. Every $1 invested in vaccination yielded estimated savings of $10.19 (95% CrI, $9.39-$10.87) in direct and indirect costs of health outcomes that would have been incurred without vaccination.
Results of this modeling study showed an association of the New York City COVID-19 vaccination campaign with reduction in severe outcomes and avoidance of substantial economic losses. This significant ROI supports continued investment in improving vaccine uptake during the ongoing pandemic.
纽约市是大流行的早期中心之一，为减轻疾病爆发的负担，在 COVID-19 疫苗接种活动上投入了大量资金。了解该活动的投资回报率 (ROI) 将为遏制未来 COVID-19 爆发的疫苗接种计划提供见解。
通过从社会角度估计有形的直接和间接成本，估算纽约市 COVID-19 疫苗接种活动的投资回报率。
设计、设置和参与者：本疾病传播决策分析模型通过对 2020 年 12 月 14 日至 2022 年 1 月 31 日期间纽约市确诊和可能的 COVID-19 病例进行校准。使用同一时期报告的住院和死亡的实际模式对该模拟模型进行了验证。
使用校准模型模拟了没有疫苗接种的基于代理的反事实情景。
使用接种疫苗的实际大流行轨迹和没有疫苗接种的反事实情景估计了医疗保健费用和死亡人数。还估计了因接种疫苗而减少的门诊就诊、急诊就诊、紧急医疗服务、住院和重症监护病房入院等情况所带来的节省。还考虑了 COVID-19 死亡导致的统计生命损失价值 (VSL) 和疾病导致的生产力损失，以计算投资回报率。
在研究期间，疫苗接种活动避免了估计 279.6 亿美元（95%可信区间 [CrI]，261.9 亿至 298.4 亿美元）的医疗支出和 315724 年（95%CrI，292143 至 340420 年）的潜在寿命损失，避免了 VSL 损失 262.7 亿美元（95%CrI，243.9 亿至 282.1 亿美元）。估计疫苗接种带来的净节省为 517.7 亿美元（95%CrI，485 亿至 558.5 亿美元）。每投资 1 美元用于疫苗接种，估计可节省 51.99 美元（95%CrI，49.39 美元至 58.87 美元），用于避免在没有疫苗接种的情况下发生的直接和间接医疗费用。
这项建模研究的结果表明，纽约市 COVID-19 疫苗接种活动与严重后果的减少和大量经济损失的避免有关。这一显著的投资回报率支持在持续大流行期间继续投资提高疫苗接种率。
