Tuesday, June 18, 2024

Cost-Effectiveness of South Africa’s COVID-19 Vaccination Program Highlighted in New Study

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South Africa introduced COVID-19 vaccines in February 2021, embarking on a significant public health initiative. Over the following two years, the program’s economic and health impacts were scrutinized to determine its overall value. A retrospective assessment has revealed that the vaccination effort provided substantial benefits in terms of cost-effectiveness, especially when viewed from the perspective of public health expenditure and outcomes.

Methodology and Analysis

The study employed a model to compare the costs and health outcomes of the vaccination program against a scenario where no vaccinations were administered. Costs were calculated in 2021 US dollars, and health outcomes were measured in terms of disability-adjusted life years (DALYs). The analysis spanned two periods: nine months (February to November 2021) and twenty-four months (February 2021 to January 2023). By parameterizing a disease transmission model with data on COVID-19 hospitalizations and deaths, researchers estimated the health benefits of the vaccination program. Various sensitivity analyses were conducted to account for uncertainties in the parameters.

Key Findings

The incremental cost-effectiveness ratio (ICER) for the first nine months was calculated at $1600 per DALY averted, while for the entire twenty-four-month period, it was $1300 per DALY averted. Including 85% of all excess deaths in the analysis adjusted the ICERs to $1070 and $660 per DALY averted for the first and second periods, respectively. Notably, probabilistic sensitivity analysis (PSA) indicated that nearly all simulations fell below South Africa’s opportunity cost-based cost-effectiveness threshold of $2300 per DALY averted. The cost per vaccine dose emerged as the most significant factor influencing the ICERs.

Actionable Insights

– Significant health benefits are achieved with lower DALYs when high vaccination coverage is maintained.
– Reducing vaccine costs can further enhance the cost-effectiveness of the program.
– Extending the vaccination program’s timeline can potentially increase its economic and health benefits.
– Prioritizing high-risk populations may yield better cost-effectiveness outcomes.


The research demonstrates that South Africa’s COVID-19 vaccination program was highly cost-effective during its initial two years. The findings suggest that the program represented good value for money, supporting the continuation and expansion of vaccination efforts in the country. By averting significant health costs and improving public health outcomes, the vaccination efforts underscore the importance of sustained investment in immunization programs.

Original Article: Vaccine. 2024 May 31:S0264-410X(24)00595-4. doi: 10.1016/j.vaccine.2024.05.036. Online ahead of print.

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