Modeling the potential public health and economic impact and cost-effectiveness of vaccination strategies using an adapted COVID-19 vaccine in the Dominican Republic

This peer-reviewed article by Pfizer researchers, models the public health and economic impact of vaccinating adults aged ≥65 years and high-risk adults aged 18-64 with an adapted COVID-19 vaccine in the Dominican Republic. Using a country-adapted Markov–decision tree model built on national surveillance, cost, and quality-of-life data, the study estimates outcomes over a one-year horizon from both public payer and societal perspectives, with scenario analyses testing broader age eligibility and case-underreporting assumptions.

Key Insights

• Vaccinating adults aged ≥65 and high-risk adults aged 18-64 was estimated to prevent 9,272 symptomatic cases, 88 hospitalizations, and 3 deaths, and gain 239 QALYs over one year compared with no vaccination.
• The strategy generated estimated direct cost savings of US$11.1 million and societal cost savings of US$12.7 million.
• Expanding eligibility to adults aged ≥60 and high-risk adults aged 18–59 further increased benefits, preventing 10,904 symptomatic cases and saving US$14.1 million from a societal perspective.
• Findings were robust across most scenarios but sensitive to assumptions regarding the degree of COVID-19 case underreporting.
• The authors conclude that continued use of adapted COVID-19 vaccines targeting populations at greatest risk could provide substantial health and economic benefits in the Dominican Republic despite the lower disease burden observed in the post-pandemic period.

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