As the United States prepares for the rollout of an updated COVID-19 vaccine, new research underscores the economic value of continued broad vaccination. The study finds that vaccinating every adult over 65 with a single dose of the updated mRNA vaccine would ultimately save more money than it costs, thanks to its ability to prevent hospitalisations, deaths, long- and short-term illness, and productivity losses such as missed workdays. The findings are based on a computer model that excluded people with immune-compromising conditions.

The research also highlights benefits for middle-aged adults, showing that vaccinating people aged 50 to 64 represents a sound economic investment. Even among healthy young adults aged 18 to 49, the study concludes that broad vaccination could be cost-effective under certain conditions. For older adults, a second dose of the vaccine was found to be economically favourable, while in those under 64 without immune compromise, it was not.

Published in JAMA Network Open, the study comes from a team led by University of Michigan researchers Lisa Prosser and David Hutton, who have long collaborated with the U.S. Centers for Disease Control and Prevention (CDC) on vaccine cost-effectiveness research. Their model estimates that for every 100,000 vaccinated adults over 65, 391 hospitalisations and 43 deaths could be prevented. Among those aged 18 to 49, vaccination could prevent around 39 hospitalisations and one death per 100,000. Across all age groups, between 7,600 and 8,900 cases of COVID-19 of any severity could be avoided.

Despite these findings, vaccination uptake has waned. CDC data show that as of early 2025, only 28% of Medicare beneficiaries over 65 had received the latest vaccine, while just 23% of adults of all ages reported being vaccinated. Still, COVID-19 remains a significant cause of death, with over 47,000 Americans listed as having died from it in 2024, although this represents a substantial decline from earlier in the pandemic.

This work builds on earlier studies by Prosser and colleagues demonstrating that the national vaccine effort in 2020 and 2021 more than paid for itself within a year, largely by offsetting medical costs. The team’s model incorporates a wide range of factors, from vaccine costs and COVID-19 testing to treatment expenses, lost productivity, and the risk of long-term post-COVID conditions. Importantly, the estimates are conservative, meaning the actual economic benefits may be even greater.

The CDC currently recommends that everyone over six months of age receive at least one dose of the updated COVID-19 vaccine, with older adults and those who are immunocompromised advised to obtain a second dose six months later. Although hospitalisation rates for COVID-19 have declined, researchers caution that continued vaccination remains both a life-saving and economically sound strategy, particularly for older populations.

More information: Lisa Prosser et al, Cost-Effectiveness of 2023-2024 COVID-19 Vaccination in US Adults, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.23688

Journal information: JAMA Network Open Provided by Michigan Medicine – University of Michigan