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. 2023 Mar 10;41(11):1885-1891.
doi: 10.1016/j.vaccine.2023.01.068. Epub 2023 Feb 1.

The societal value of SARS-CoV-2 booster vaccination in Indonesia

Rob Johnson  1 , Bimandra Djaafara  2 , David Haw  3 , Patrick Doohan  3 , Giovanni Forchini  4 , Matteo Pianella  3 , Neil Ferguson  3 , Peter C Smith  5 , Katharina D Hauck  3
Affiliations

The societal value of SARS-CoV-2 booster vaccination in Indonesia

Rob Johnson et al. Vaccine. .

Abstract

Objectives: To estimate the expected socio-economic value of booster vaccination in terms of averted deaths and averted closures of businesses and schools using simulation modelling.

Methods: The value of booster vaccination in Indonesia is estimated by comparing simulated societal costs under a twelve-month, 187-million-dose Moderna booster vaccination campaign to costs without boosters. The costs of an epidemic and its mitigation consist of lost lives, economic closures and lost education; cost-minimising non-pharmaceutical mitigation is chosen for each scenario.

Results: The cost-minimising non-pharmaceutical mitigation depends on the availability of vaccines: the differences between the two scenarios are 14 to 19 million years of in-person education and $153 to $204 billion in economic activity. The value of the booster campaign ranges from $2,500 ($1,400-$4,100) to $2,800 ($1,700-$4,600) per dose in the first year, depending on life-year valuations.

Conclusions: The societal benefits of booster vaccination are substantial. Much of the value of vaccination resides in the reduced need for costly non-pharmaceutical mitigation. We propose cost minimisation as a tool for policy decision-making and valuation of vaccination, taking into account all socio-economic costs, and not averted deaths alone.

Keywords: COVID-19; Economics; Education; Non-pharmaceutical; Vaccination.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Optimal trajectories of mitigation via closures with and without a booster vaccination campaign for low and high life-year valuations ($20,000 and $80,000). Note: Business closures are defined relative to a reference configuration, so that a relative closure of 0 is full openness and of 4 is the maximum possible closure (see Appendix 4.2 for details). The counterfactual has no boosters, and the booster campaign has 80% vaccination coverage at twelve months. We constrain the configuration to be constant for the first four months, then allow a linear increase in opening over six months, and then fix the achieved configuration for the remaining two months of the projection horizon. Costs are evaluated for the full twelve-month period. The figures show that booster vaccination allows both schools and businesses to open earlier. The low valuation is associated with a more open trajectory.
Figure 2
Figure 2
Total socio-economic cost estimates for the scenarios and estimated value of the booster campaign. Notes: shown is (a) the distribution over total socio-economic costs (TSC) for the counterfactual (no boosters) and the booster scenario (80% booster coverage) for all life-year valuations (VLY), and (b) the societal value of the booster campaign considering uncertainty in key parameters (Transmission modifier, vaccine escape, hospitalisation rate, and VSY): the value of the campaign is the TSC for the counterfactual less the TSC for the booster scenario. Central points indicate medians, and boxes indicate the interquartile range. Whiskers extend to three times the interquartile range on either side, with points beyond that plotted individually.
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