05 COVID Prosser 508

Economic analysis of
COVID -19 vaccination
University of Michigan
COVID -19 Vaccination Modeling Team
ACIP Meeting
June 24, 2024
1

 Study team
University of Michigan
• Lisa A. Prosser, PhD, Principal Investigator
• David W. Hutton, PhD, Co -Investigator
• Acham Gebremariam, MS, Programmer/Analyst
• Angela Rose, MS, MPH, Project Manager
• Christina Nyamuswa, Research Assistant
Wake Forest University
• Cara Janusz, PhD Centers for Disease Control and Prevention
• Jamie Pike, PhD, Health Economist, Project officer
• Megan Wallace, DrPH, Epidemiologist
• Ismael Ortega -Sanchez, PhD, Senior Economist
• Andrew Leidner, PhD, Economist
• Fangjun Zhou, PhD, Health Scientist
• Melisa Shah, MD, MPH, Medical Epidemiologist
• Danielle Moulia, MPH, Health Scientist
• Ruth Link -Gelles, PhD, Epidemiologist
• Sharon Saydah, PhD, Epidemiologist
2

 Expert panelists – Pediatric Model
Matthew Daley, MD, University of Colorado School of Medicine
Rachel Gross, MD, New York University Grossman School of Medicine
Sean O’Leary, MD, University of Colorado School of Medicine
Peter Szilagyi, MD, MPH, University of California, Los Angeles
3
  Conflict of interest statement
Authors have no known conflicts of interest.
4

          Objectives
• Original aims*:
o
o
o
o Estimate annual disease burden and healthcare utilization associated with COVID -19
illness and COVID -19 booster vaccination, including cases of symptomatic illness,
hospitalizations, deaths, adverse events, costs, and quality -adjusted life years
Project cost -effectiveness of an updated mRNA booster against COVID -19-associated
illness in persons ages ≥18 years
• Update s for this Phase 3 model:
Addition of pediatric age groups: 5 -11y, 12 -17y
Updates to adult model to reflect rapidly evolving evidence base
* Earlier analyses from this model were presented to ACIP in September 2023 and February 2024: Prosser, Lisa A. (2023). Economic Analysis of Vaccination with mRNA
Booster Dose against COVID -19 Among Adults; Prosser, Lisa A (2024). Economic analysis of an additional dose of COVID -19 vaccine
5

   Phase 3 Updates
Pediatric Model -new Adult Model -  revised
1. Epidemiologic inputs
2. Seasonality -adjusted vaccine
impact
3. Cost inputs
4. Quality Adjustments 1.Epidemiologic inputs
• Hospitalization rates – more recent, lower
• Probability of Long COVID -stratified by
illness severity
2.Cost inputs
• Costs & productivity losses associated with
Long COVID -updated
• Vaccine dose cost -updated to CDC list
price
3.Quality adjustments
• Symptomatic illness -updated
6
Methods
7
Model
schematic
No ventilator
Ventilator Symptomatic
COVID -19
(non -hospitalized)
Hospitalized
COVID -19 Non -medically
attended
Outpatient visit
No ICU
admission
ICU admission B
No
complications
Long COVID B
D Death No
COVID -19
COVID -19 No Long COVID
Long COVID
Long -term
sequelae No
complications
Long COVID
Death ED visit B
No ventilator
Ventilator C
D C
Updated COVID -
19 vaccination,
1-dose strategy
A
A
A No updated
COVID -19
vaccination
A A
No side
effects
Systemic
reaction
Anaphylaxis
Severe
adverse event

ED = emergency department; ICU = intensive care unit 8

 Analysis Plan
• Project health and economic outcomes stratified by intervention strategy and by
age subgroups (5 -11y, 12 -17y, 18 -49y, 50 -64y, 65+y)
o Cases
o Hospitalizations
o Deaths
o Costs
o QALYs
o Adverse events
• Calculate incremental cost -effectiveness ratios comparing updated COVID -19
vaccination to no updated vaccination (societal perspective)
• Conduct base case and uncertainty analyses (one -way sensitivity and scenario
analyses)
9
  Model inputs
10

      Probability of symptomatic illness, annualized
Age Base case Range for sensitivity analysis Source
Low High
5-11 years 0.3145 0.1790 0.4510 Assumption
based on adult
data* 12-17 years 0.3145 0.1790 0.4510
18-49 years 0.3145 0.2858 0.3444 HEROES -
RECOVER
Dec 2022 -May
2023 50-64 years 0.2841 0.2438 0.3274
65+ years 0.3339 0.2312 0.4510
*Base case assumed to be the same as 18 -49 years with a wider range for sensitivity analysis
Unchanged from Phase 2 11

                              40
Weekly  rates  of
COVID- 19
associated
hospitalizations
by  season,  all
ages 30
20
10 Hospitalization rate per 100,000 2021- 2022
2020- 2021
2022- 2023
2019- 2020
2023- 2024
12 Oct    Nov    Dec  Jan Feb Mar Apr     May    Jun  Jul    Aug Sep
0

     Probability of hospitalization, annualized
0.008 0.0079
0.007
0.006
0.005
0.004
0.003
0.002 0.00155
0.001 0.000133 0.000181 0.000443
0
5-11 12-17 18-49 50-64 65+
years years years years years Age Base case Range for sensitivity analysis
Low High
5-11 years 0.000133 0.000034 0.000336
12-17 years 0.000181 0.000039 0.000456
18-49 years 0.000443 0.000101 0.002040
50-64 years 0.001550 0.000413 0.004790
65+ years 0.007900 0.002450 0.020900
Source: Derived using COVID -NET data (October 2022 -September 2023) adjusted by the probability of hospitalization attributable t o COVID -19 by
quarter. The upper limit is from COVID -NET data (October 2022 -March 2023), unadjusted by the probability of hospitalization attr ibutable to COVID -19.
13

    Probability and duration of Long COVID, by age
Age group Initial illness
severity Probability of
Long COVID Range for sensitivity
analysis
Low High Median
duration
(months) Source
Symptomatic 0.002 0.002 0.003 5.8
Assumption
5-17 y Outpatient 0.005 0.003 0.006 7.6 based on adult
Hospitalized 0.008 0.003 0.013 8.9 data*
Symptomatic 0.011 0.009 0.013 5.8 INSPIRE,
unpublished data
18+ y Outpatient
Hospitalized 0.023
0.040 0.017
0.017 0.029
0.064 7.6
8.9 Dec 2020 -Mar
2023. Montoy and
Ford, 2023**
* Duration assumed to be the same as 18+ y. Probabilities c alibrated to national data from the National Center for Health Statistics
(Vahratian 2023)
** Derived using data on extreme fatigue and cognitive difficulties from INSPIRE ( Montoy and Ford 2023, INSPIRE unpublished data)
calibrated to national data from the National Center for Health Statistics (Adjaye -Gbewonyo 2023)
14

0 33 66 99 132 165 198 231 264 297 330 3630 33 66 99 132 165 198 231 264 297 330 363Seasonality-adjusted vaccine impact
Vaccine effectiveness against ED/UC,  5 - 17 y Cases averted 5 -11 y
3.0 100%
90%
2.5 Optimistic 80%
71%
70%

  48%
Base case Conservative
Hospitalizations per 100,000 Cases averted Cases Vaccine effectiveness
10%
0.0 0% 2.0
60%
1.5 50%
40%
30%
20% 1.0
0.5
Oct  Nov   Dec    Jan  Feb    Mar   Apr May Jun Jul Aug  Sep Oct   Nov Dec Jan Feb   Mar   Apr May Jun  Jul Aug Sep
Age Base case Range for sensitivity analysis Source
Low High
5-11 years 0.423 0.133 0.711 VISION
unpublished data*
*Sept 2023 -May 2024
ED = emergency department; UC = urgent care 15

  Seasonality -adjusted vaccine impact against
symptomatic illness/hospitalization
Age Base case Range for sensitivity analysis Source
Low High
5-11 years 0.423 0.133 0.711 VISION,
Assumption* 12-17 years 0.422 0.136 0.713
18-49 years 0.360 0.140 0.475 VISION, IVY ,
seasonality
adjusted** 50-64 years 0.357 0.141 0.475
65+ years 0.347 0.134 0.468
* VISION data for Sept 2023 -May 2024, adjusted VE against emergency department/urgent care visits was applied to pediatric age -group
specific hospitalization rates from COVID -NET to derive seasonality -adjusted vaccine impact
** Using data on bivalent booster data from Sep 2022 -May 2023. Range includes minimum and maximum from both data sources, min:
conservative approach (VE at 180 days=0) and max: optimistic approach (VE at 180 days=VE at 365 days); assumed same VE for sy mptomatic
illness as hospitalization, seasonality adjusted
16
5-11 years
35
30
25 Hospitalizations per 100,000 20
15 Base Case Alternative #1 (winter peak)
10
Alternative 2 (spring peak) 5
0 Alternative seasonality assumptions – winter, spring peaks
12-17 years
35
30 25 Hospitalizations per 100,000 20
15
10
5
0
Oct  Nov   Dec   Jan Feb    Mar   Apr May Jun  Jul   Aug  Sep Oct  Nov   Dec   Jan Feb    Mar   Apr May Jun  Jul   Aug  Sep
0 5 10 15 20 25 30 35 Hospitalizations per 100,000 18-49 years
0 5 10 15 20 25 30 35 Hospitalizations per 100,000 50-64 years
0 20 40 60 80 100 120 140 160 180 200 Hospitalizations per 100,000 65+ years
Oct  Nov   Dec   Jan Feb    Mar   Apr May Jun  Jul   Aug  Sep Oct  Nov   Dec   Jan Feb    Mar   Apr May Jun  Jul   Aug  Sep Oct  Nov   Dec   Jan Feb    Mar   Apr May Jun  Jul   Aug  Sep

1 2 3 4 5 6 7 8 9 10 11 121 2 3 4 5 6 7 8 9 10 11 12
1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 121 2 3 4 5 6 7 8 9 10 11 12
17

 Vaccination -related costs
• Direct medical costs of vaccine dose, administration fee, and adverse events
• Time costs for recipients or caregivers; vary by setting; children ages 5 -11 years most likely to be
vaccinated in physician office setting
Table. Vaccine dose cost
Age Base case Range for sensitivity analysis Source
Low* High
5-11 years ** $89 $30 $130 CDC Vaccine
Price List 12-17 years** $102 $30 $130
18+ years *** $119 $30 $130
* Lower bound reflects price of bivalent boosters as of March 2023.
** Assumes 50% CDC contract pricing and 50% private sector pricing
***Assumes 12.8% receive vaccines through government programs (Source: CDC unpublished data)
Note: Age 12+ private sector/CDC contract prices: Moderna $ 128/$85.91; Novavax $130/$58; Pfizer $115/$97.75
Age 5 -11 private sector/CDC contract prices: Moderna $ 128/$85.91; Pfizer $77/$65.45
Costing year: 2023
18

 Direct medical costs (supplementary slides)
• Vaccination -related adverse events
• OTC & prescription medications for medically -attended non -
hospitalized illness
• Outpatient visit (claims data)
• Emergency department visit
• Hospitalizations with and without complications (ventilator
assistance, ICU stay)
• Long COVID – pediatric estimates based on adult data
OTC = over the counter medications; ICU = intensive care unit
19

  Time costs/productivity losses*
(supplementary slides)
• Vaccination receipt
• Vaccination -related adverse events
• Outpatient visit
• Emergency department visit
• Hospitalizations with and without complications (ventilator
assistance, ICU stay)
• Long COVID
• Deaths
*Caregiver time costs or productivity losses for pediatric age groups
ICU = intensive care unit
20

    QALYs lost, COVID -19 illness & hospitalization
Range for Sensitivity Analysis Age Base Case Low High
Symptomatic illness
5-17 years 0.0057 0.0030 0.0085
18+ years 0.0046 0.0018 0.0074
Hospitalization, no ICU stay
5-17 years 0.0189 0.0054 0.0325
18+ years 0.0174 0.0038 0.0310
Hospitalization, with ICU stay, ventilator assistance
5-17 years 0.0883 0.0632 0.1169
18+ years 0.0394 0.0231 0.0583
ICU = intensive care unit; QALD = quality -adjusted life day; QALY = quality -adjusted life year QALD
2.1
(1.1 – 3.1)
1.7
(0.7 – 2.7)
6.9
(2.0 – 11.9)
6.4
(1.4 – 11.3)
32.2
(23.1 – 42.7)
14.4
(8.5 – 21.3) Source
Soare 2023
Soare 2023
Mercon 2023
21
Results
22

         Disaggregated results, per 100,000 people,
preliminary estimates
Age
group Strategy Health outcomes Health outcomes averted
Cases Long
COVID Hosp ICU Deaths Cases Long
COVID Hosp ICU Deaths
5-11 y No updated vax 31,450 71 13.3 2.7 0.12 - - - - -
Updated Covid -19 vax, 1 -dose 18,147 41 7.7 1.6 0.07 13,303 30 5.6 1.2 0.05
12-17 y No updated vax 31,450 72 18.1 3.8 0.12 - - - - -
Updated Covid -19 vax, 1 -dose 18,178 41 10.5 2.2 0.07 13,272 30 7.6 1.6 0.05
18-49 y No updated vax 31,450 413 44.3 5.8 0.59 - - - - -
Updated Covid -19 vax, 1 -dose 20,128 265 28.4 3.1 0.32 11,322 149 15.9 2.7 0.26
50-64y No updated vax 28,410 396 155.0 29.9 4.99 - - - - -
Updated Covid -19 vax, 1 -dose 18,268 255 99.7 16.2 2.80 10,142 142 55.3 13.7 2.19
65+ y No updated vax 33,390 501 790.0 105.9 40.06 - - - - -
Updated Covid -19 vax, 1 -dose 21,804 327 515.9 58.1 23.47 11,586 174 274.1 47.7 16.59
Hosp = hospitalizations; ICU = intensive care unit stays
23

0 10,000 20,000 30,000 40,000 50,000
5-11 y 12-17 y 18-49 y 50-64y 65+ y COVID-19 cases
0 200 400 600 800 1000
5-11 y 12-17 y 18-49 y 50-64y 65+ y Long COVID Cases 1000 Hospitalizations
800
600
400
200
0
 Disaggregated results, per 100,000 people,
preliminary estimates
5-11 y 12-17 y 18-49 y 50-64y 65+ y
150 ICU stays
120
90
60
30
ICU = intensive care unit
0 24
5-11 y 12-17 y 18-49 y 50-64y 65+ y 0 30 60 90 120 150
5-11 y 12-17 y 18-49 y 50-64y 65+ y Deaths

 Incremental cost -effectiveness ratios,
societal perspective, per 1000 people,
preliminary estimates
Age
group Strategy Projected
Costs Incremental
Costs Projected
QALYs Incremental
QALYs $/QALY
5-11 y No updated vax $38,124 - 26,788 - -
Updated Covid -19 vax, 1 -dose $188,339 $150,215 26,789 0.7494 $200,445
12-17 y No updated vax $45,219 - 24,638 - -
Updated Covid -19 vax, 1 -dose $198,613 $153,394 24,639 0.7570 $202,621
18-49 y No updated vax $131,991 - 20,208 - -
Updated Covid -19 vax, 1 -dose $261,080 $129,089 20,209 0.6083 $212,225
50-64y No updated vax $237,902 - 12,278 - -
Updated Covid -19 vax, 1 -dose $326,508 $88,606 12,279 0.7824 $113,248
65+ y No updated vax $363,304 - 6,525 - -
Updated Covid -19 vax, 1 -dose $403,428 $40,124 6,527 1.7215 $23,308
QALY = quality -adjusted life year
25

 Incremental  cost-effectiveness  ratios,
preliminary  estimates
Age group Societal perspective
$/QALY
5-11 y $200,445
12-17 y $202,621
18-49 y $212,225
50-64y $113,248
65+ y $23,308
QALY = quality -adjusted life year
26

 One way sensitivity analyses, 5 -11 y
preliminary estimates
Vaccine impact, symptomatic illnes/hospitalization(0.711, 0.133)
QALYs lost, symptomatic COVID-19 (0.009, 0.003)
Probability, symptomatic COVID-19 (0.451, 0.179)
Cost, vaccine dose ($30, $130)
Time (h) spent to receive vaccine (0.170, 2)
Probability, hospitalization given symptomatic COVID-19 (0.00003, 0.00034)
Cost, vaccine administration per dose ($20.30, $28.90)
QALYs lost, systemic reaction (0.0001, 0.0004)
Time (h) spend to receive vaccine, pharmacy (0.083, 0.500)
Proportion, patients with productivity loss due to Long COVID (1, 0.250)
0 100,000 200,000 300,000 400,000 500,000 600,000 700,000
$/QALY
Base case: $200,445
Note: Numbers in parentheses indicate input values for sensitivity analysis
QALY = quality -adjusted life year 27

 One way sensitivity analyses, 18 -49 y
preliminary estimates
Vaccine impact, symptomatic illness/hospitalization (0.475, 0.140)
QALYs lost, symptomatic COVID-19 (0.007, 0.002)
Cost, vaccine dose ($30, $130)
Probability, hospitalization given symptomatic COVID-19 (0.0020, 0.0001)
Probability, symptomatic COVID-19 (0.344, 0.286)
Productivity loss, Long COVID (1, 0.250)
Probability, systemic reaction (0.073, 0.148)
Time (h) spent to receive vaccine (0.170, 2)
Vaccine impact, critical illness/death (0.664, 0.287)
Proportion, patients with productivity loss due to Long COVID (1, 0.250)
 100,000 200,000 0 300,000 400,000 500,000 600,000 700,000
$/QALY
Base case: $212,225
Note: Numbers in parentheses indicate input values for sensitivity analysis
QALY = quality -adjusted life year 28

   Scenario analysis: probability of symptomatic illness*,
ICER ($/QALY)
preliminary estimates
Age group Base case**
0.1 Probability of symptomatic illness
0.2 0.3 0.4 0.5
5-11 y $200,445 $722,624 $331,876 $211,334 $152,732 $118,088
12-17 y $202,621 $714,398 $334,103 $213,584 $154,431 $119,286
18-49 y $212,225 $709,386 $356,815 $224,808 $155,707 $113,199
50-64 y $113,248 $264,675 $162,297 $106,065 $70,517 $46,014
65+ y $23,308 $48,896 $36,178 $26,213 $18,195 $11,603
*One -way sensitivity analysis of non -hospitalized symptomatic illness varied separately from hospitalization and critical illnes s
**Base case probability of symptomatic illness: 5 -49 y: 0.3145; 50 -64 y: 0.2841; 65+ y: 0.3339
ICER = incremental cost-effectiveness ratio; QALY=Quality -adjusted life year
29

   Scenario analysis: probability of hospitalization,
ICER ($/QALY)
preliminary estimates
Age group Base case* Probability of hospitalization**
¼ base case ½ base case 2x base case 3x base case 4x base case
5-11 y $200,445 $206,836 $204,683 $192,231 $184,349 $176,779
12-17 y $202,621 $210,339 $207,740 $192,689 $183,146 $173,970
18-49 y $212,225 $243,483 $232,548 $176,831 $147,052 $121,649
50-64 y $113,248 $214,304 $173,146 $41,319 Cost saving Cost saving
65+ y $23,308 $133,631 $78,440 Cost saving Cost saving Cost saving
*Base case probability of h ospitalization: 5-11 years: 0 .000133; 12-17 years: 0.000181; 18 -49 years: 0.000443; 50 -64 years: 0.001550; 65+
years 0.007900
**Adjusted risk of hospitalization by underlying condition: chronic obstructive pulmonary disease: 0.9, history of stroke: 0. 9, coronary artery
disease: 1.3, asthma: 1.4, hypertension: 2.8, obesity: 2.9, diabetes: 3.2, chronic kidney disease: 4.0, severe obesity: 4.4. Ko et al 2021.
ICER = incremental cost-effectiveness ratio; QALY = Quality -adjusted life year
30

     Scenario analysis: All Long COVID submodel parameters*,
ICER ($/QALY)
preliminary estimates
Age group Base case Long COVID submodel parameters
All low All high
5-11 y $200,445 $206,021 $188,365
12-17 y $202,621 $208,341 $190,416
18-49 y $212,225 $247,483 $160,934
50-64 y $113,248 $139,203 $74,095
65+ y $23,308 $28,118 $15,148
*Long COVID probabilities, costs, productivity losses and quality adjustments varied simultaneously
ICER = incremental cost-effectiveness ratio; QALY = Quality -adjusted life year
31

 Vaccine impact scenario analysis, ICER ($/QALY),
preliminary estimates
Base case Scenario 1
All lower bounds Scenario 2
All upper bounds
5-11 y $200,445 $780,660 $108,061
12-17 y $202,621 $750,981 $107,709
18-49 y $212,225 $672,057 $138,503
50-64 y $113,248 $396,767 $52,024
65+ y $23,308 $141,215 Cost saving
QALY = quality -adjusted life year
32

   Scenario analysis: alternative seasonality scenarios,
ICER ($/QALY),
preliminary estimates
Base case Alternative seasonality
scenario #1
winter peak Alternative seasonality
scenario #2
spring peak
5-11 y $200,445 $229,108 $226,324
12-17 y $202,621 $230,316 $228,911
18-49 y $212,225 $264,075 $296,491
50-64 y $113,248 $135,556 $168,275
65+ y $23,308 $27,392 $42,660
ICER = incremental cost-effectiveness ratio; QALY = quality -adjusted life year
33

   Scenario analysis: vaccine dose cost, ICER ($/QALY),
preliminary estimates
Age group Base case* Vaccine dose cost
$30 $50 $70 $90 $110 $130
5-11 y $200,445 $121,596 $148,284 $174,971 $201,659 $228,347 $255,035
12-17 y $202,621 $106,933 $133,352 $159,770 $186,188 $212,607 $239,025
18-49 y $212,225 $66,351 $99,231 $132,112 $164,992 $197,873 $230,753
50-64 y $113,248 Cost saving $25,403 $50,965 $76,528 $102,090 $127,652
65+ y $23,308 Cost saving Cost saving Cost saving $6,618 $18,236 $29,854
*Base case vaccine cost: 5 -11 y: $89.09; 12 -17 y: $102.44; 18+ y: $118.73
ICER = incremental cost-effectiveness ratio; QALY = quality -adjusted life year
34

   Multi -way sensitivity analysis: vaccination -related costs,
ICER ($/QALY)
preliminary estimates
Age group Base case Vaccination -related costs*
All low All high
5-11 y $200,445 $88,225 $292,895
12-17 y $202,621 $79,777 $271,786
18-49 y $212,225 $39,518 $267,101
50-64 y $113,248 Cost saving $155,887
65+ y $23,308 Cost saving $43,137
*Vaccination related and adverse event related costs and productivity losses varied simultaneously
ICER = incremental cost-effectiveness ratio; QALY = Quality -adjusted life year
35

 Limitations
• Data sources vary in representativeness, generalizability
• Unpublished data used to derive key parameters in the model: vaccine impact,
symptomatic illness, probabilities of hospitalization and critical illness
• VE estimates derived from a single season
• Few seasons to date to estimate seasonality
• Model does not include reduced transmission (conservative approach)
• Claims data used to estimate costs includes only supplemental insurance for 65+
• Evidence base for Long COVID is especially scarce, even more so for pediatric age
groups
• Rapidly evolving evidence base; as critical illness attributable to COVID -19 illness
declines, mild/moderate illness and Long COVID could become primary drivers of
cost-effectiveness
36

  Summary -preliminary estimates
➢Vaccination averts morbidity and mortality for all age groups, but with substantial variation in
impact by age
➢Adult age groups
• Phase 3 model projects somewhat less  favorable results overall due to declining burden of illness
• ICERs for 65+ age group [$23,000/QALY] are robust to changes in parameter inputs across plausible
ranges [cost saving -$117,000/QALY]
• ICERs for 18 -49y [$212,000/QALY] and 50 -64y [$113,000/QALY] age groups are sensitive to changes in
parameter inputs Parameter Age ICER range ($/QALY)
Vaccine impact 18-49 y $145,000 – $616,000
50-64 y $68,000 – $296,000
QOL impact, symptomatic illness 18-49 y $140,000 – $443,000
50-64 y $83,000 – $178,000
Vaccine dose cost 18-49 y $66,000 – $231,000
50-64 y cost saving – $128,000
Risk of hospitalization 18-49 y $108,000 – $244,000
50-64 y cost saving – $211,000
37

   Summary -preliminary estimates (2)
➢Pediatric age groups
• ICERs for 5 -11y [$200,000/QALY] and 12 -17y [$203,000/QALY] age groups are very sensitive to
changes in parameter inputs
Parameter Age ICER range ($/QALY)
Vaccine impact 5 -11 y $110,000 -$743,000
12 -17 y $109,000 -$720,000
QOL impact, symptomatic illness 5 -11 y $134,000 -$385,000
12 -17 y $136,000 -$385,000
Probability, symptomatic illness 5 -11 y $133,000 -$375,000
12 -17 y $135,000 -$377,000
Vaccine dose cost 5 -11 y $107,000 -$239,000
12 -17 y $107,000 -$239,000
• Evidence base for pediatric age groups overall less robust
• Estimated results reflect higher degree of uncertainty compared with adult age groups
38

Summary: Economic analysis of  COVID -19 vaccination  University of Michigan  COVID -19 Vaccination Modeling Team  ACIP Meeting  June 24, 2024  1                    Study team  University of Michigan  • Lisa A. Prosser, PhD, Principal Investigator  • David W. Hutton, PhD, Co -Investigator  • Acham Gebremariam, MS, Programmer/Analyst  • Angela Rose, MS, MPH, Project Manager  • Christina Nyamuswa, Research Assistant  Wake Forest University  • Cara Janusz, PhD Centers for Disease Control and Prevention  •…