The nation saved significantly more on healthcare expenditures and lost productivity than it invested in the testing, procurement, and distribution of the 2021 vaccines

Five years back, volunteers participated in the inaugural clinical trial for a vaccine targeting COVID-19 while the burgeoning pandemic unfolded around them. By the subsequent year, 66 million American adults had received at least one dose of a COVID-19 vaccine, at no expense to them.

Currently, a fresh investigation reveals the astuteness of that national investment in testing, acquiring, and administering the initial vaccines.

Altogether, the national vaccination initiative recouped its costs after merely one year, as detailed in the new findings published in the journal Vaccine by a team spearheaded by researchers from the University of Michigan. Owing to the vaccines’ effectiveness in reducing the incidence of serious illness and mortality among adults, the United States reaped more financial benefits than it expended, according to the study.

The evaluation encompasses not just the expenses associated with COVID-19 treatment but also the costs related to testing, treating individuals, managing post-COVID conditions, as well as rare vaccine side effects, alongside productivity costs stemming from lost workdays due to illness or death.

Even excluding productivity losses, the national COVID-19 vaccination campaign saved more in averted healthcare costs for adults over 40 than the expenditures made for the vaccine campaign targeting this demographic.

For adults between 18 and 39, who are less prone to severe COVID-19 complications, the vaccination effort incurred slightly higher costs than the total medical expenses averted; nonetheless, it remained cost-effective within national standards. Factoring in lost productivity, vaccinating this younger population proved financially beneficial.

The University of Michigan team that conducted the research has also shared insights regarding the cost-effectiveness of various vaccines at meetings hosted by the Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practices, which formulates vaccine usage recommendations.

“Overall, we can confidently assert that this was a sound investment for the American populace, based on a notably conservative analysis,” stated Lisa Prosser, the lead author of the recent study and a professor at the Medical School and School of Public Health. “Evaluating from a broader societal economic standpoint and considering medical care expenditures, the federal government’s initiative to expedite vaccine testing, procure substantial quantities of vaccines, and underwrite vaccination expenses in numerous scenarios was astute.”

Prosser and senior author David Hutton, a professor at the School of Public Health and College of Engineering, collaborated to establish and assess the model, which draws from the research outcomes of multiple teams that have examined various dimensions of COVID-19.

The model encompasses all aspects from the cost of the vaccine itself, to at-home or laboratory tests for the virus, to the probability of experiencing any degree of COVID-19 illness or vaccine side effect, to the standard expenses linked with care for different illness severities, to the number of workdays lost due to varying degrees of illness.

The researchers also accounted for post-COVID conditions—long COVID and PASC (Post-Acute Sequelae of COVID-19).

The model employs conservative estimations, suggesting the actual savings may be even greater than reported in the study, according to Prosser.

For example, it excludes the productivity loss from individuals who took time off to care for an unwell family member, patients’ out-of-pocket expenses for treatment or transportation to access healthcare. It also omits the foundational laboratory science investments made by the federal government over the past two decades that paved the way for the two mRNA vaccines developed by Pfizer/BioNTech and Moderna.

Prosser, Hutton, and their colleagues have conducted further economic modeling following waves of vaccination post-2021 in cooperation with the Centers for Disease Control and Prevention. They are aiming to create a model for the revised versions of the vaccines anticipated to be released in fall 2025, contingent on CDC funding and data.

This winter, Prosser mentioned that widespread vaccinations and enhanced treatments have lowered both the fatality rate from COVID-19 and the occurrence of cases severe enough to necessitate emergency or hospitalization.

Nevertheless, between 575 and 1,000 individuals died from COVID-19 weekly throughout 2025, based on complete data accessible as of early April. Additionally, about 1% of all emergency department visits in recent months resulted from COVID-19-related illnesses.

Prosser pointed out that the present CDC guidelines recommend all individuals over six months old receive at least one dose of one of the three updated vaccines made available in September 2023, with annual updates now in effect. To date, approximately 30 million individuals have done so, including around 30% of those aged 65 and above, who face the highest risk of severe COVID-19 complications upon infection.

For those aged 65 and older or immunocompromised due to a health condition or treatment, the CDC advises a second dose of the current vaccine six months following the initial dose.

This implies that individuals who received the updated vaccine shortly after its release in September should now seek a second dose.

Study co-authors: Janamarie Perroud, Grace Chung, Acham Gebremariam, Cara B. Janusz, Kerra Mercon, Angela Rose, Anton Avanceña, and Ellen Kim DeLuca. All are or were previously associated with the U-M School of Public Health or the Susan B. Meister Child Health and Evaluation Research Center, which is part of the U-M Medical School’s Department of Pediatrics that financed the study. Prosser and Hutton are affiliated with the U-M Institute for Healthcare Policy and Innovation.

Written by Kara Gavin, Michigan Medicine, Institute for Healthcare Policy and Innovation