# P-1515. The Socioeconomic Value of Adult Respiratory Vaccination in the United States: A Benefit-Cost Analysis

## TL;DR

This study shows that adult respiratory vaccination in the US provides huge economic benefits, with returns on investment growing over time.

## Contribution

The first comprehensive benefit-cost analysis of combined adult respiratory vaccination programs in the US.

## Key findings

- Combined adult respiratory vaccination averts over 12,000 deaths and saves 1.2 million hospital bed days in the first year.
- Net benefits reach $5.1 trillion over the lifetime of all cohorts, with a benefit-cost ratio of 9:1.
- Benefits grow significantly over time, reaching $1.3 trillion in net benefits by year 10.

## Abstract

In the United States, protection from respiratory diseases via vaccination is recommended against seasonal influenza (flu) and COVID-19 for adults aged 18+, Pneumococcal Disease (PD) for adults 50+ and at-risk adults aged 18-49, and Respiratory Syncytial Virus (RSV) for adults 75+ and at-risk adults aged 60-74.

Each of these respiratory vaccines can reduce mortality, morbidity, as well as burdens on the healthcare system, and evaluations have found them cost-effective from payer and societal perspectives.

However, there is currently a lack of evidence evaluating the combined socioeconomic value of adult respiratory vaccination.

We quantified the socioeconomic value of vaccinating adults against PD, RSV, flu, and COVID-19 in the US, using an established Benefit-Cost Analysis (BCA) framework.

This included valuing i) mortality risk reduction using the Value of a Statistical Life approach, ii) morbidity risk reduction using the Cost-of-Illness approach, and iii) changes in time use using formal work productivity losses.

Four static, deterministic disease models were developed to estimate outcomes. We compared a vaccination strategy reflecting the current Advisory Committee on Immunization Practices’ vaccine recommendations to a comparator strategy of no vaccination.

We calculated Benefit-Cost Ratios (BCRs) and Net Benefits (NBs) by aggregating benefits and costs across all cohorts and programs at years 1, 5, 10 and over the lifetime.

At year 1, all programs combined avert over 12,000 deaths, free up more than 1.2 million hospital bed days and 3.6 million outpatient visits. This results in NBs of $132.5 billion, corresponding to a BCR of 5:1. NBs grow over time to $659.8 billion in year 5 (BCR 7:1), $1.3 trillion in year 10 (BCR 7:1) and to over $5.1 trillion (BCR 9:1) over all cohorts’ lifetimes.

Adult respiratory vaccination programs generate a significant socioeconomic value with benefits greatly exceeding their costs. This study informs US decision-makers of the societal return on investment, and advocates for sustained adult vaccine recommendations to prevent respiratory diseases.

Tianyan Hu, PhD, Pfizer: Salary|Pfizer: Stocks/Bonds (Public Company) Matthew W. Napier, MSc Health Economics and Health Policy, Amicus Therapeutics: Grant/Research Support|Astellas: Grant/Research Support|MSD: Grant/Research Support|Organon: Grant/Research Support|Pfizer: Grant/Research Support|Takeda: Grant/Research Support|ViiV: Grant/Research Support Alon Yehoshua, PharmD, MS, Pfizer Inc: Employee of Pfizer and may hold stock or stock options of Pfizer Jeffrey T. Vietri, PhD, Pfizer Inc: Employment|Pfizer Inc: Stocks/Bonds (Public Company) Claud Theakston, MSc, Grunenthal: Grant/Research Support|J&J: Grant/Research Support|MSD: Grant/Research Support|Novartis: Grant/Research Support|Pfizer: Grant/Research Support|Roche: Grant/Research Support|Sanofi: Grant/Research Support|Santen: Grant/Research Support Sulayman Z. Chowdhury, MSc, Big Health: Grant/Research Support|Grunenthal: Grant/Research Support|Novartis: Grant/Research Support|Pfizer: Grant/Research Support Diana Mendes, PhD, Pfizer: Salary|Pfizer: Stocks/Bonds (Private Company) Simon Brassel, MSc, Dipl.-Ing., GSK: Grant/Research Support|Johnson & Johnson: Grant/Research Support|Moderna: Grant/Research Support|Pfizer: Grant/Research Support|Sanofi: Grant/Research Support|ViiV: Grant/Research Support Raymond Farkouh, PhD, Pfizer: Stocks/Bonds (Public Company) Lotte Steuten, MSc, PhD, Amgen: Grant/Research Support|Astra Zeneca: Grant/Research Support|Biomerieux: Grant/Research Support|GSK: Grant/Research Support|Moderna: Grant/Research Support|MSD/Merck: Grant/Research Support|Pfizer: Grant/Research Support|ViiV: Grant/Research Support