Modeling the potential public health and economic impact and cost-effectiveness of vaccination strategies using a COVID-19 vaccine in Costa Rica

This peer-reviewed evaluates the potential public health impact, economic outcomes, and cost-effectiveness of different adapted COVID-19 vaccination strategies in Costa Rica. The study used an adapted combined Markov decision-tree model to compare vaccination strategies using the BNT162b2 COVID-19 mRNA vaccine against no vaccination, focusing on older adults and high-risk populations. The analysis incorporated Costa Rica-specific epidemiological, healthcare utilization, cost, and quality-of-life data, alongside published regional evidence where local data were unavailable.

Key findings 

• Vaccinating adults aged ≥65 years and high-risk individuals aged 18–64 years was projected to prevent 3,704 symptomatic COVID-19 cases, 35 hospitalizations, approximately 1 death, and 102 lost QALYs.
• The vaccination strategy generated estimated direct medical cost savings of US$9.5 million and societal cost savings of US$10.6 million compared with no vaccination.
• Expanding eligibility to adults aged ≥60 years and high-risk individuals aged 18–59 years further increased projected health gains and cost savings.
• Vaccination remained cost-saving and dominant across all scenario and sensitivity analyses, including conservative assumptions on infection underreporting and long COVID burden.
• Increasing vaccine coverage substantially improved the projected public health and economic impact of vaccination strategies in Costa Rica.

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