In a new study published in BMJ Global Health, researchers use a dynamic transmission-immunological modelling framework to evaluate various COVID-19 booster strategies during the early post-Omicron period, across different demographic and immune background scenarios. They integrate data on immunity (from prior infection and vaccination), transmission dynamics, clinical outcomes (infections, hospitalisations, deaths), and costs of vaccination and healthcare. The modelling considers several country income–level settings, incorporating vaccine costs and health-care utilization patterns typical in the Western Pacific region. Their simulation compares booster strategies (e.g. targeting older adults, broader eligibility, boosting frequency) against a counterfactual of no further boosting, estimating incremental costs and disability-adjusted life years (DALYs) averted.
The key findings indicate that annual boosters targeting older age groups are most likely to be cost-effective (or even cost-saving) under many settings — in high-income settings, there is >75% probability of cost-effectiveness, and in younger or middle-income settings, >50%. Broad or pediatric booster programs are generally less favorable economically. More frequent boosting (e.g. every six months) might only be justifiable in high-income settings with older populations and high willingness-to-pay thresholds. The results are sensitive to parameters such as vaccine price, costs of home-based care, and immunological assumptions. The authors conclude that booster vaccine deployment should be strategically targeted under resource constraints, prioritizing age groups at highest risk to maximize health impact per dollar spent.
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