Modeling the Potential Public Health Impact and Cost-Effectiveness of BNT162B2 COVID-19 Booster Vaccination in Mexico

OBJECTIVES: This study assessed the public health impact and cost-effectiveness of a booster strategy with BNT162b2 COVID-19 vaccine in Mexico.

METHODS: A combined Markov and decision tree model was used to estimate the economic and public health impact of vaccination strategies targeting various age groups in Mexico over a one-year time horizon. Age-stratified annual attack rates of cases, hospitalizations, and deaths, and vaccine coverage rates were informed by the literature and local surveillance data for the Omicron period. Other age-stratified clinical, cost, and vaccine effectiveness parameters were informed by local and international sources and the literature.

RESULTS: A BNT162b2 COVID-19 vaccination strategy targeting individuals aged ≥65 years and the high-risk population aged 12-64 years was estimated to avert 1,509,194 symptomatic cases, 24,575 deaths, 132,166 hospitalizations, and 276,223 lost quality-adjusted life years (QALYs). Direct medical costs increased by MXN 11 billion, but total societal costs decreased by MXN 44 billion. Vaccination was cost-saving from the societal perspective and from the payer perspective had an ICER of MXN 42,944, which is very cost-effective based on a willingness-to-pay threshold of MXN 231,395 (GDP per capita).

CONCLUSIONS: A vaccination strategy targeting individuals aged ≥65 years and those aged 12-64 years at high risk yields substantial public health and economic gains annually. Including a broader range of ages in vaccination strategies may be an important public health strategy and offer cost-saving (dominant) from the societal perspective or cost-effective from the payer perspective.