J Med Econ. 2026 Dec;29(1):940-956. doi: 10.1080/13696998.2026.2643130. Epub 2026 Mar 24.
ABSTRACT
BACKGROUND: COVID-19 annual vaccination uptake in Spain remains suboptimal. This study aimed to estimate the clinical and economic impact of the 2023/2024 COVID-19 vaccination campaign in individuals aged ≥60 years (scenario A: coverage of 33.14% for ages 60-69, 53.15% for 70-79, and 65.32% for ≥80), and to compare it with a hypothetical scenario (scenario B) where coverage reaches the 75% target set by the Spanish Ministry of Health.
METHODS: A combined Markov-decision tree model adapted to the Spanish context simulated the weekly progression of the target population through six health states over one year. Infected individuals entered a decision tree reflecting different care pathways (outpatient, hospital ward, ICU with/without invasive mechanical ventilation [IMV], or death), each associated with specific health outcomes and direct costs (€2024). Clinical and economic outcomes were compared between scenarios A and B. Sensitivity analyses explored incremental increases in coverage and age-specific impacts. The analysis was conducted from the National Healthcare System (NHS) perspective.
RESULTS: Under scenario A, 378,970 symptomatic infections occurred, leading to 27,611 hospitalizations, 742 ICU admissions (47.3% requiring IMV), and 3,611 deaths. A total of 2,750 quality-adjusted life years (QALYs) were lost, and COVID-19-related care costs reached €240.4 million (85.7% from inpatient care). Scenario B, with 75% coverage, averted -19,409 symptomatic infections, 1,094 hospitalizations, 41 ICU admissions, and 129 deaths, 138 lost QALYs and total cost savings of about €10.5 million. Sensitivity analysis showed how the model is sensitive to sequential increases (10% by 10%) in vaccination rates and highlighted the importance of achieving high vaccination rates, especially in older age groups.
CONCLUSIONS: This analysis reveals the significant impact that increasing annual COVID-19 vaccination coverage among the Spanish population over 60 could have in preventing new infections, reducing severe disease consequences, and generating considerable cost savings for the NHS.
PMID:41874460 | DOI:10.1080/13696998.2026.2643130
