Return on Investment of the COVID-19 Vaccination Campaign in New York City

Abstract

This decision analytical model estimates the direct and indirect costs as well as the benefits associated with a citywide COVID-19 vaccination initiative in New York City.

Key Points

Question

Did the economic savings accrued from reductions in COVID-19 cases, hospitalizations, and deaths outweigh the investment in the COVID-19 vaccination program in New York City?

Findings

In this decision analytical model study of a citywide initiative, every $1 invested in the New York City vaccination campaign yielded an estimated $10.19 in cost savings from lower infection and mortality rates, fewer productivity losses, and averted health care use.

Meaning

Findings of this study suggest that COVID-19 vaccination in New York City was associated with reduction in severe outcomes and avoidance of substantial economic losses.

Abstract

Importance

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.

Objective

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.

Exposures

An agent-based counterfactual scenario without vaccination was simulated using the calibrated model.

Main Outcomes and Measures

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.

Results

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.

Conclusions and Relevance

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.