Summary
A global model-based economic evaluation estimates that COVID-19 vaccination generated $59.7–$809 in net benefits per dollar invested during its first year. The estimates vary with how the health benefits are valued.
A peer-reviewed global economic evaluation estimates that COVID-19 vaccination generated $59.7–$809 in net benefits for every dollar invested in vaccine development and delivery during the programme’s first year, from 8 December 2020 to 8 December 2021. The range reflects different methods for putting a monetary value on health gains, rather than money returned as revenue or cash savings.
The researchers estimated total development and delivery costs of $79.4 billion. They valued the benefits at $6.43 trillion under an undiscounted cost-effectiveness analysis and $64.3 trillion under a cost-benefit analysis. In the cost-effectiveness analysis, discounting future health gains at 3% brought the estimated benefit value to $4.82 trillion.
How the researchers calculated the returns
The evaluation covered 173 countries and used estimates from a previously published transmission model of COVID-19 vaccination’s impact. That model compared the observed vaccination rollout with a scenario in which no vaccines were administered, while other conditions—including public-health restrictions, behaviour and variant emergence—were held as observed. The economic study estimated that vaccination averted 1.50 billion infections and 51.5 million hospitalisations in the period assessed.
The researchers then valued those health effects in two ways. The cost-benefit analysis used estimates of the value of a statistical life, which represent people’s willingness to pay for small reductions in mortality risk. It also counted healthcare and productivity costs avoided. This approach produced an estimated $64.3 trillion in benefits.
The cost-effectiveness analysis valued health gains in quality-adjusted life years, or QALYs—a measure combining length of life and health-related quality of life. The researchers assigned monetary values to QALYs using estimates of the health gains that healthcare spending can produce. This approach estimated $6.43 trillion in undiscounted benefits, or $4.82 trillion after discounting. The study also estimated $564 billion in avoided productivity costs and $222 billion in avoided healthcare costs.
Using the study’s return-on-investment formula, (benefits minus costs) divided by costs, the base-case net returns ranged from $59.7 to $809 per dollar invested. The cost-benefit analysis produced the higher figure, largely because it assigned a substantial monetary value to deaths averted. In a probabilistic sensitivity analysis, the reported ROI estimates were 753 for the cost-benefit approach (95% uncertainty interval: 309–1,559) and 60.3 for discounted cost-effectiveness analysis (95% uncertainty interval: 23.8–81.7).
What the estimates mean
Both approaches produced returns well above the study’s break-even point of one. The result suggests that, within the assumptions and time period assessed, the health and economic value of vaccination substantially outweighed the estimated costs of developing, manufacturing and delivering the vaccines. The two methods value health differently, so their dollar estimates—and the resulting ROI figures—are not interchangeable measures of financial profit.
The analysis also found differences between income groups. High-income countries had the greatest health benefits per person vaccinated, while low-income countries had the greatest productivity and healthcare cost savings per person vaccinated when those savings were compared with GDP per capita. The authors identify unequal access and differences in rollout timing as important context for these disparities.
The estimates depend on a modelled comparison with a no-vaccine scenario, including the assumption that other pandemic conditions would have remained as observed without vaccination. The evaluation covers only the first year of the programme. Its delivery-cost estimate, drawn from a study of lower-middle-income countries, was applied across the countries included in the analysis. The authors also note uncertainty in vaccine manufacturing and delivery costs and in the health-utility values used to calculate QALYs. These factors matter when interpreting the precise ROI, while both valuation approaches in the analysis still estimated net returns above one.