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Background: Currently, increasing regions have realized that universal vaccination are necessary to prevent COVID-19. However many of them are facing problems associated with insufficient supply or chaotic allocation of vaccines. This study selected the United States population as an example and explored prioritization strategies of COVID-19 vaccination for different age groups to achieve the highest economic efficiency.Methods: We built a dynamic transmission model to predict the incidence of SARS-CoV-2 infections under the prioritization strategies of vaccination for different ages within a 180-day simulation period. Quality-adjusted life year (QALY) was selected as the outcome. Medical costs included direct medical cost and vaccine cost based on a healthcare system perspective. Data on SARS-CoV-2 epidemiology, vaccine efficacy, and medical costs were derived from publicly available databases and previously published literature. Different COVID-19 vaccines were included in scenario analysis. The robustness of the study results was evaluated by one-way sensitivity analysis and probabilistic sensitivity analysis.Results: COVID-19 vaccination is economical compared with no vaccination. Priority vaccination for adults aged 25–59 years saves $31,664.2 million and that for adults over 60 years old saves $30,082.9 million in medical costs compared with no vaccine intervention. Additionally, priority vaccination for adults aged 25–59 years vs. over 60 years old saves $1,581.3 million. In contrast, priority vaccination for adults aged over 60 years vs. 25–59 years old gains 0.001 QALYs and costs $4.7 per capita, with an incremental cost-effectiveness ratio of $4,829.3/QALY, and it is economical when taking gross domestic product per capita of the United States in 2020 as the willingness-to-pay threshold. The results of sensitivity analysis indicate that the base-case results are robust.Conclusions: From a healthcare system perspective, it is most economical to prioritize adults aged over 60 years for COVID-19 vaccination in the United States, thereby achieving effective resource allocation and saving the government costs. |
