Key takeaways
- COVID-19 generates a major economic burden, even after the pandemic. The costs from lost productivity due to COVID-19 are about twice as high as healthcare system costs in Australia and Japan, seven times larger in the UK, and ten times larger in the Netherlands.
- Investing in COVID-19 vaccines is not just a health need, it’s an economic imperative. Vaccines help protect societies and reduce pressure on healthcare systems, while supporting economic stability by keeping people working and productive. Continued investment in comprehensive vaccination policies and COVID-19 vaccines is essential to reduce its ongoing and future burden.
- Extending COVID-19 vaccination eligibility to working-age adults could nearly triple the benefits to national economies. Compared to the status quo, this approach would further reduce sick days, long-term disability, and workforce dropouts caused by short-term illness and long COVID, generating substantial additional benefit to national economies.
Why investigating the economic case for ongoing COVID-19 vaccination matters
While public health strategies around COVID-19 have transitioned from a pandemic to an endemic setting, the disease remains a persistent and evolving threat characterised by year-round viral activity, surges, and an ongoing health and economic burden. Nevertheless, recommendations for routine COVID-19 immunisation have become increasingly restrictive worldwide, predominantly focusing on older adults (≥65 years) and population groups at risk of severe outcomes, and largely exclude healthy working-age adults. Whereas the latter group are less likely to suffer severe health outcomes leading to hospitalisation, they may still experience symptomatic illness and long-term consequences, through potential exacerbation of underlying conditions, leading to lost productivity. This lost productivity means that COVID-19 infections in the working-age population have a greater impact on the national economy.
Using a cost-of-illness analysis based on 2024 cost data, this report investigates the economic burden of COVID-19 during the post-pandemic era and the potential economic benefits of ongoing immunisation for healthcare systems and national economies. This report focuses on four high-income countries currently recommending COVID-19 vaccination to older and at-risk adults, namely the United Kingdom, Australia, Japan and the Netherlands.
COVID-19 continues to represent a significant economic burden
We estimate that without annual autumn vaccination of older adults, the economic burden of COVID-19 is substantial, averaging 0.48% of national GDP across the countries studied (min%-max%: 0.26%-0.97%).
ANNUAL ECONOMIC BURDEN OF COVID-19 IN CASE OF NO VACCINATION PROGRAMME
| United Kingdom | Australia | Japan | The Netherlands | |
| TOTAL | £6.98 bn | A$7.35 bn | ¥ 5.75 tn | €3.99 bn |
| TOTAL AS A % OF NATIONAL GDP* | 0.26% | 0.28% | 0.97% | 0.39% |
This impact is twice the average pre-pandemic national spending on health prevention in OECD countries, and significantly surpasses the economic costs of other respiratory infections such as influenza, highlighting its continued impact in the post-pandemic era. National economies bear a disproportionate share of the COVID-19 burden – twice as large as the COVID-19 related healthcare system costs in Australia and Japan, more than seven times as large in the UK, and ten times as large in the Netherlands.
Annual vaccination of older adults and high-risk groups protects healthcare systems but leaves national economies exposed to the impact of COVID-19
Annual autumn COVID-19 vaccination of older adults (aged 60+ in the Netherlands and 65+ in the UK, Australia and Japan) and at-risk groups, aligned with 2023/2024 national recommendations [1], prevents significant healthcare costs and pressure. Based on 2023/2024 recommendations, COVID-19 vaccination programs reduce healthcare burden by preventing 22% of COVID-19-related costs on average (min%-max%: 13%-29%), primarily through averting severe cases and hospitalisations. This highlights the vital role of annual vaccination strategies in protecting healthcare systems from additional winter pressure due to seasonal infections. However, the economic benefits to national economies are more modest, with 7% of economic losses averted (min%-max%: 3%-12%) under vaccination strategies aligned with 2023/2024 recommendations.
Extending annual vaccination to the working-age population could triple the economic benefits of COVID-19 vaccination programmes to national economies
Extending vaccination eligibility to the general population aged 50 and over could avert on average 13% (min%-max%: 5%-25%) of costs to the national economy, while extending vaccination eligibility to the population aged 18 and over2 could increase the proportion of the economic burden of COVID-19 on the national economy averted to 27% on average (min%-max%: 8%-60%). Extended vaccination policies could address the significant burden on national economies caused by absenteeism, long-term workforce attrition, and consequent productivity losses linked to both acute and long COVID cases.
Long COVID is likely a major contributor to economic losses due to prolonged absenteeism and reduced workforce participation. Though the full impact of long COVID is difficult to quantify and compare due to a lack of systematic data across countries, estimates suggest that long COVID alone could account for up to 49% of COVID-19 economic costs on the national economy in some countries, underscoring the need for continued vaccination to mitigate these impacts.
Policy recommendations
This report demonstrates the enduring economic burden posed by COVID-19 and highlights the transformative potential of COVID-19 vaccination strategies. While annual autumn vaccination programmes for older adults and at-risk groups effectively reduce healthcare system pressures, extending vaccination to younger working-age populations can unlock broader economic benefits and long-term societal resilience. Maintaining and expanding these efforts is vital to mitigate both current and future impacts of COVID-19.
Vaccination of the general population of older adults and groups at risk should be maintained as a cornerstone of resilient healthcare systems
Increasingly limited vaccine recommendations and excluding population groups at risk of severe outcomes hinder the ambition to build resilient healthcare systems. A more explicit and systematic recognition of vaccines’ ability to mitigate pressure on healthcare system capacity in health technology assessment and vaccination policies would be consistent with this objective.
A decision-making and funding approach to annual immunisation that appreciates broader economic benefits is needed
Now more than ever, it is essential to recognise the broader value of interventions, such as vaccines, in decision-making and funding, especially as they help maintain healthy and productive societies. This is particularly urgent in the face of global trends like demographic ageing and increasing rates of chronic illness among working-age adults. Without this broader perspective, decision-makers risk overlooking the role of public health investments in supporting long-term economic productivity.
This contract research report, The broader economic benefits of COVID-19 vaccination, was commissioned and funded by Moderna.