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. 2024 Jan 11:68:102369.
doi: 10.1016/j.eclinm.2023.102369. eCollection 2024 Feb.

The potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine: a modelling study

Sarah M Bartsch  1   2   3 , Kelly J O'Shea  1   2   3 , Danielle C John  1   2   3 , Ulrich Strych  4 , Maria Elena Bottazzi  4   5 , Marie F Martinez  1   2   3 , Allan Ciciriello  4 , Kevin L Chin  1   2   3 , Colleen Weatherwax  1   2   3 , Kavya Velmurugan  1   2   3 , Jessie Heneghan  1   2   3 , Sheryl A Scannell  1   2   3 , Peter J Hotez  4   5 , Bruce Y Lee  1   2   3
Affiliations

The potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine: a modelling study

Sarah M Bartsch et al. EClinicalMedicine. .

Abstract

Background: With efforts underway to develop a universal coronavirus vaccine, otherwise known as a pan-coronavirus vaccine, this is the time to offer potential funders, researchers, and manufacturers guidance on the potential value of such a vaccine and how this value may change with differing vaccine and vaccination characteristics.

Methods: Using a computational model representing the United States (U.S.) population, the spread of SARS-CoV-2 and the various clinical and economic outcomes of COVID-19 such as hospitalisations, deaths, quality-adjusted life years (QALYs) lost, productivity losses, direct medical costs, and total societal costs, we explored the impact of a universal vaccine under different circumstances. We developed and populated this model using data reported by the CDC as well as observational studies conducted during the COVID-19 pandemic.

Findings: A pan-coronavirus vaccine would be cost saving in the U.S. as a standalone intervention as long as its vaccine efficacy is ≥10% and vaccination coverage is ≥10%. Every 1% increase in efficacy between 10% and 50% could avert an additional 395,000 infections and save $1.0 billion in total societal costs ($45.3 million in productivity losses, $1.1 billion in direct medical costs). It would remain cost saving even when a strain-specific coronavirus vaccine would be subsequently available, as long as it takes at least 2-3 months to develop, test, and bring that more specific vaccine to the market.

Interpretation: Our results provide support for the development and stockpiling of a pan-coronavirus vaccine and help delineate the vaccine characteristics to aim for in development of such a vaccine.

Funding: The National Science Foundation, the Agency for Healthcare Research and Quality, the National Institute of General Medical Sciences, the National Center for Advancing Translational Sciences, and the City University of New York.

Keywords: Coronavirus; Economic; Modelling; Universal; Vaccine.

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Conflict of interest statement

PJH, MEB, and US are co-inventors of a COVID-19 recombinant protein vaccine technology owned by Baylor College of Medicine (BCM) that was recently licensed by BCM non-exclusively and with no patent restrictions to several companies committed to advance vaccines for low- and middle-income countries. The co-inventors have no involvement in license negotiations conducted by BCM. Similar to other research universities, a long-standing BCM policy provides its faculty and staff, who make discoveries that result in a commercial license, a share of any royalty income, according to BCM policy. SMB, KJO, DCJ, MFM, AC, KLC, CW, KV, JH, SAS, and BYL declare no competing interests.

Figures

Fig. 1
Fig. 1
Model Structure A) SARS transmission; and B) clinical outcomes probability tree.
Fig. 2
Fig. 2
Clinical outcomes (mean, 95% confidence interval) averted (A–C) and societal cost savings yielded (D–F) by using a universal coronavirus vaccine (costing $60) when it is the only intervention available and how it varies with vaccine efficacy (assuming it wanes to 0% at 6 months) and coverage.
Fig. 3
Fig. 3
Vaccination cost and vaccine efficacy thresholds at which a universal coronavirus vaccine is cost saving and cost-effective (cost per disability-adjusted life year averted) from the societal perspective when A) the universal vaccine is the only intervention available; and B) when it is used as a stopgap measure prior to a strain-specific vaccine becoming available.
Fig. 4
Fig. 4
Clinical outcomes (mean, 95% confidence interval) averted (A–C) and societal cost savings yielded (D) by using a universal coronavirus vaccine (25% coverage in 2 months) when a strain-specific vaccine (90% efficacy, 70% coverage in 2 months) does not become available until later in the pandemic.
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