The Potential Impact of COVID-19 Vaccine Efficacy and Vaccination Coverage on Health Equity Among United States (US) Older Adults
Author(s)
Keya Joshi, PhD1, Mariia Dronova, PhD2, Ewelina Paterak, MSc2, Justyna Sambor, MSc2, Nicolas Van de Velde, MBA, MSc, PhD1, Ekkehard Beck, MSc, PhD3;
1Moderna, Inc, Boston, MA, USA, 2Putnam, Krakow, Poland, 3Moderna, Munich, Germany
1Moderna, Inc, Boston, MA, USA, 2Putnam, Krakow, Poland, 3Moderna, Munich, Germany
OBJECTIVES: There continues to be a significant burden of severe COVID-19 disease in US older adults (≥65-years). Evaluation of health equity for vaccines in the US often focus on disease burden and access to vaccines/vaccination coverage rates (VCR) stratified by race and ethnicity. The study objectives were to estimate the impact of (1) a hypothetical 1-dose Moderna next-generation COVID-19 mRNA-1283 vaccine compared to currently recommended COVID-19 mRNA vaccines during the 2024/2025 season, and (2) increase in COVID-19 VCR on health equity among US adults ≥65-years.
METHODS: A published COVID-19 health economic model was adapted to incorporate race- and ethnicity-specific input parameters. These included age-adjusted COVID-19 hospitalization and mortality rates, VCRs (2023/2024 season), life expectancy, and baseline utilities. Vaccine efficacy estimates for mRNA-1283 and the market-mix of current mRNA-1273 and BNT162b2 vaccines were derived from the NextCOVE trial, real-world data, and an indirect treatment comparison. The impact on health equity across five race and ethnicity subgroups was evaluated using an absolute gap index (hospitalizations per 100,000 population) and the equity-efficiency plane for Atkinson and Kolm-Pollak social welfare functions.
RESULTS: Assuming higher vaccine efficacy of mRNA-1283 during the 2024/2025 season compared to currently available mRNA vaccines, health inequalities among US adults ≥65-years decreased, with reduction in the absolute gap (-29/100,000), positive net-health benefit (+49,161 QALYs), and net-equity impact (Atkinson: +0.00000195; Kolm-Pollak: +0.00000060). Increasing COVID-19 VCR by 10% across race and ethnicity subgroups for current mRNA vaccines also reduced health inequalities, with reduction in absolute gap (-10/100,000), positive net-health benefit (+16,237 QALYs) and net-equity impact (Atkinson: +0.00000057; Kolm-Pollak: +0.00000016).
CONCLUSIONS: Results suggest that mRNA-1283 may reduce health inequalities among US adults ≥65-years compared to current vaccines. The similar magnitude of equity impact from higher vaccine efficacy and from increasing COVID-19 VCR underscores the need for including differences in vaccine efficacy in health equity evaluations and policy.
METHODS: A published COVID-19 health economic model was adapted to incorporate race- and ethnicity-specific input parameters. These included age-adjusted COVID-19 hospitalization and mortality rates, VCRs (2023/2024 season), life expectancy, and baseline utilities. Vaccine efficacy estimates for mRNA-1283 and the market-mix of current mRNA-1273 and BNT162b2 vaccines were derived from the NextCOVE trial, real-world data, and an indirect treatment comparison. The impact on health equity across five race and ethnicity subgroups was evaluated using an absolute gap index (hospitalizations per 100,000 population) and the equity-efficiency plane for Atkinson and Kolm-Pollak social welfare functions.
RESULTS: Assuming higher vaccine efficacy of mRNA-1283 during the 2024/2025 season compared to currently available mRNA vaccines, health inequalities among US adults ≥65-years decreased, with reduction in the absolute gap (-29/100,000), positive net-health benefit (+49,161 QALYs), and net-equity impact (Atkinson: +0.00000195; Kolm-Pollak: +0.00000060). Increasing COVID-19 VCR by 10% across race and ethnicity subgroups for current mRNA vaccines also reduced health inequalities, with reduction in absolute gap (-10/100,000), positive net-health benefit (+16,237 QALYs) and net-equity impact (Atkinson: +0.00000057; Kolm-Pollak: +0.00000016).
CONCLUSIONS: Results suggest that mRNA-1283 may reduce health inequalities among US adults ≥65-years compared to current vaccines. The similar magnitude of equity impact from higher vaccine efficacy and from increasing COVID-19 VCR underscores the need for including differences in vaccine efficacy in health equity evaluations and policy.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE133
Topic
Economic Evaluation
Topic Subcategory
Novel & Social Elements of Value
Disease
STA: Vaccines