mRNA-based COVID-19 booster vaccination is highly effective and cost-effective in Australia

Rui Li, Hanting Liu, Christopher K. Fairley, Jason J. Ong, Yuming Guo, Pengyi Lu, Zhuoru Zou, Li Xie, Guihua Zhuang, Yan Li, Mingwang Shen, Lei Zhang

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)


Background: Australia implemented an mRNA-based booster vaccination strategy against the COVID-19 Omicron variant in November 2021. We aimed to evaluate the effectiveness and cost-effectiveness of the booster strategy over 180 days. Methods: We developed a decision-analytic Markov model of COVID-19 to evaluate the cost-effectiveness of a booster strategy (administered 3 months after 2nd dose) in those aged ≥ 16 years, from a healthcare system perspective. The willingness-to-pay threshold was chosen as A$ 50,000. Results: Compared with 2-doses of COVID-19 vaccines without a booster, Australia's booster strategy would incur an additional cost of A$0.88 billion but save A$1.28 billion in direct medical cost and gain 670 quality-adjusted life years (QALYs) in 180 days of its implementation. This suggested the booster strategy is cost-saving, corresponding to a benefit-cost ratio of 1.45 and a net monetary benefit of A$0.43 billion. The strategy would prevent 1.32 million new infections, 65,170 hospitalisations, 6,927 ICU admissions and 1,348 deaths from COVID-19 in 180 days. Further, a universal booster strategy of having all individuals vaccinated with the booster shot immediately once their eligibility is met would have resulted in a gain of 1,599 QALYs, a net monetary benefit of A$1.46 billion and a benefit-cost ratio of 1.95 in 180 days. Conclusion: The COVID-19 booster strategy implemented in Australia is likely to be effective and cost-effective for the Omicron epidemic. Universal booster vaccination would have further improved its effectiveness and cost-effectiveness.

Original languageEnglish
Pages (from-to)2439-2446
Number of pages8
Issue number15
Publication statusPublished - 6 Apr 2023


  • Australia
  • Booster
  • Cost-effective analysis
  • COVID-19
  • Markov model

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