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. 2024 Oct;13(10):2155-2177.
doi: 10.1007/s40121-024-01032-y. Epub 2024 Sep 10.

Public Health and Economic Impact of Periodic COVID-19 Vaccination with BNT162b2 for Old Adults and High-Risk Patients in an Illustrative Prefecture of Japan: A Budget Impact Analysis

Mitsuhiro Nagano #  1 , Kosuke Tanabe #  2 , Kazumasa Kamei  3 , Sooyeol Lim  4 , Honoka Nakamura  4 , Shuhei Ito  2
Affiliations

Public Health and Economic Impact of Periodic COVID-19 Vaccination with BNT162b2 for Old Adults and High-Risk Patients in an Illustrative Prefecture of Japan: A Budget Impact Analysis

Mitsuhiro Nagano et al. Infect Dis Ther. 2024 Oct.

Abstract

Introduction: Japan will be transitioning from the free-of-charge COVID-19 vaccination program to annual periodic vaccination under a national immunization program for old adults and high-risk patients from 2024 fall/winter season. The policy transition including out-of-pocket payment requirement may discourage vaccination, leading to a lower vaccination rate. This study aimed to estimate the impact of varying vaccination rates with BNT162b2 COVID-19 mRNA vaccine on economics and public health in an illustrative prefecture which administers and promotes the periodic vaccination program, using budget impact analysis.

Methods: A combined cohort Markov decision tree model estimated the public health outcomes of COVID-19-related symptomatic cases, hospitalizations and deaths; and the economic outcomes including vaccine-related cost, non-vaccine-related medical cost, and productivity loss from the societal perspective. The base case examined the impact on the outcomes when vaccination coverage changed from the reference value of 50% to upper and lower values, respectively. Scenario analyses were performed based on multiple scenarios.

Results: Increase in the vaccination rate demonstrated improvement in all public health outcomes. At 50% vaccination, the vaccine-related cost for 3 years in a prefecture was estimated at JPY 7.58 billion (USD 57.67 million), the non-vaccine-related medical cost at JPY 79.22 billion (USD 602.48 million), the productivity loss at JPY 253.11 billion (USD 1.92 billion), and the total cost at JPY 339.92 billion (USD 2.59 billion). When the vaccination rate increased to 90%, the total cost decreased by JPY 4.88 billion (USD 37.11 million) (1.4%). When the vaccination rate decreased to 10%, the total cost increased by JPY 5.73 billion (USD 43.58 million) (1.7%). Results were consistent across almost all scenario analyses.

Conclusions: Maintaining a high vaccination rate with BNT162b2 is important from both public health and economic perspectives in Japan. The findings highlight to local governments the importance of continued effort to promote vaccination.

Keywords: BNT162b2; Booster; Budget impact analysis; COVID-19; Japan; National immunization program; Periodic vaccination; Pfizer-BioNTech Vaccine; SARS-CoV-2.

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Conflict of interest statement

The authors declare the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: M Nagano, K Tanabe, K Kamei, and S Ito are full-time employees of Pfizer Japan Inc., and hold stock of Pfizer Inc. S Lim and H Nakamura are full-time employees of INTAGE Healthcare Inc.

Figures

Fig. 1
Fig. 1
Markov cohort model structure. WE waning earlier vaccination; WP waning periodic vaccination; WNI waning of natural immunity; AR attack rate; CE coverage for earlier vaccination; CP coverage for periodic vaccination (assumed reference value of 50%, higher value of 90% and lower value of 10%); EE effectiveness post earlier vaccination; EP effectiveness post periodic vaccination; EsE effectiveness against severe disease post earlier vaccination; EsP effectiveness against severe disease post periodic vaccination
Fig. 2
Fig. 2
Budget impact schematic for the base case. BNT162b2, Pfizer–BioNTech COVID-19 vaccine
Fig. 3
Fig. 3
Differences in cumulative public health and economic outcomes of COVID-19 vaccination in 3 municipalities in Prefecture X versus the reference vaccination rate of 50% across 3 years. The percentage changes in vaccine-related cost were the same in each of the three cities, and they were 80.6% (vaccination rate from 50 to 90%) and − 80.1% (vaccination rate from 50 to 10%) respectively
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