Publication date: Nov 14, 2024

Abstract Introduction: In the post-pandemic era, people with underlying medical conditions continue to be at increased risk for severe COVID-19 disease, yet COVID-19 vaccination uptake remains low. This study estimated the clinical and economic impact of updated 2023/24 Moderna COVID-19 vaccination among high-risk adults versus no updated vaccination and versus updated Pfizer/BioNTech vaccination. Methods: A static Markov model was adapted for high-risk adults, including immunocompromised (IC), chronic lung disease (CLD), chronic kidney disease (CKD), cardiovascular disease (CVD), and diabetes mellitus (DM) populations in the United States. Results: Vaccination with the updated Moderna vaccine at current coverage rates was estimated to prevent considerable COVID-19 hospitalizations in CLD (101,309), DM (97,358), CVD (47,830), IC (14,834) and CKD (13,558) populations versus no updated vaccination. Vaccination also provided net medical cost savings of $399M-2,129M (healthcare payer) and $457M-2,531M (societal perspective), depending on population. The return-on-investment was positive across all conditions ($1.10-$2.60 gain for every $1 invested). Healthcare savings increased with a relative 10% increase in current vaccination coverage ($439M-$2,342M), and from meeting US 2030 targets of 70% coverage ($1,096M-$5,707M). Based on higher vaccine effectiveness observed in real-world evidence studies, updated Moderna vaccination was estimated to prevent additional COVID-19 hospitalizations in DM (13,105), CLD (10,359), CVD (6,241), IC (1,979), and CKD (942) versus Pfizer/BioNTech’s updated vaccine, with healthcare payer and societal cost savings, making it the dominant strategy. Healthcare savings per patient vaccinated with Moderna versus Pfizer/BioNTech’s updated vaccine were $31-59, depending on population. Results were robust across sensitivity/scenario analyses. Conclusions: Updated 2023/24 Moderna COVID-19 vaccination was estimated to provide significant health benefits through prevention of COVID-19 in high-risk populations, and cost-savings to healthcare payers and society, versus no vaccination and updated Pfizer/BioNTech vaccination. Increasing current low COVID-19 vaccination coverage rates was estimated to be cost-saving while preventing many more severe infections and hospitalizations in these high-risk populations.

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