Cost and effectiveness of COVID-19 vaccination strategies during the 2023 post-reopening omicron wave in Xinjiang, Western China: Evidence from SIR and Markov models

This peer-reviewed article evaluates the cost-effectiveness of alternative multidose COVID-19 vaccination strategies during the 2023 post-reopening Omicron wave in Xinjiang, Western China. The study used a Markov decision model based on a Susceptible–Infectious–Recovered framework, combined with field-based cost estimation, cost accounting, and literature-derived epidemiological parameters, to compare inactivated, recombinant protein, and mRNA booster strategies from a societal perspective. 

Key findings

• The analysis compared three strategies: three doses of inactivated vaccine; three doses of inactivated vaccine plus one recombinant protein booster; and three doses of inactivated vaccine plus one mRNA booster.
• Estimated treatment costs were approximately CNY 15 for mild cases, CNY 643 for moderate cases, and CNY 7,143 for severe cases.
• The vaccination administration cost, excluding vaccine price, was estimated at CNY 55.19 per dose.
• The recombinant protein booster strategy generated 462,800 QALYs at a total cost of CNY 6.552 billion, with an ICER of CNY 18,404.23 per QALY compared with three inactivated doses.
• The mRNA booster strategy produced greater health benefits at a lower total cost than the recombinant protein booster strategy, with an ICER of CNY 28,472.60 per QALY.
• The study found heterologous multidose booster strategies to be cost-effective under the epidemiological conditions of China’s 2023 Omicron-dominant post-reopening phase.

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