Baltimore, MD—Pharmacists have noticed low demand for new bivalent COVID-19 vaccine booster, and a new Commonwealth Fund study warned that, especially with limited federal funding for vaccination campaigns, uptake might not be high enough to offset the predicted surge in cases this winter.

A new study found that federal investment in vaccination campaigns could prevent thousands of hospitalizations and deaths and generate billions in savings.

Reported in a blog on the Commonwealth Fund website, the research pointed out that COVID-19 vaccination has played a central role in preventing millions of deaths and hospitalizations from SARS-CoV-2 since the first vaccines were available in late 2020.

The University of Maryland–led researchers noted that updated bivalent boosters are available for anyone who has completed their primary vaccination series and has not received any additional doses for at least 2 months.

“Boosters are a necessary part of COVID-19 mitigation because vaccine-induced and natural protection against disease have been shown to be transient. However, booster uptake in the United States has steadily declined since the initial wave of the Omicron variant, and federal financial support for vaccination campaigns has not been replenished, partly because of the perception that the pandemic is over,” the authors explained.

As of October 3, even though 68% of the total U.S. population has been vaccinated with a primary series, not even half of fully vaccinated individuals have received a booster dose. Furthermore, the authors wrote, only 36% of people aged 50 years and older have received their second booster dose.

“The rates of vaccination, including boosters, declined to less than 100,000 doses administered daily by September 12. That number is beginning to increase as more people get updated booster shots, but dwindling federal funding for vaccination threatens to undermine any goal of high coverage,” according to the blog post.

The team updated an analysis from July to examine the potential impact of a surge in cases during the upcoming fall and winter. Three scenarios were used:

• A baseline scenario where daily vaccination rates remain unchanged and two vaccine campaign scenarios in which rates increased by the end of 2022. For the baseline scenario, researchers assumed that from September 2022, vaccination will continue at the same rate as the average in August (i.e., about 28 vaccine doses per 100,000 population per day) until the end of March 2023.
• In the first vaccine campaign scenario (Scenario 1), the study estimated COVID booster uptake for the eligible population based on age-specific influenza vaccination coverage in 2020-2021 by the end of 2022.
• In the second vaccine campaign scenario (Scenario 2), the researchers assumed 80% of eligible individuals aged 5 years and older had receive their booster dose by the end of 2022.

“In the two vaccine campaign scenarios, we simulated two different fall vaccination campaigns delivering booster doses to individuals age 5 and older at increased rates between October 1 and December 31, and at baseline rates for other times,” the researchers explained.

The study team then determined the estimated impact of these potential campaigns by comparing the projected number of infections, hospitalizations, deaths, and direct medical costs from October 1 to March 31 to the baseline scenario.

The study estimated a fall booster vaccination campaign that reached coverage similar to the 2020-2021 influenza vaccination (Scenario 1) would prevent more than 75,000 deaths and more than 745,000 hospitalizations and generate savings of $44 billion associated with direct medical costs by the end of March 2023, compared with the baseline.

“An even more successful campaign (Scenario 2) would prevent approximately 90,000 deaths, more than 936,000 hospitalizations, and avert $56 billion in direct medical costs over the course of the next 6 months, compared with the baseline scenario,” the authors wrote. “If vaccination continued at its current pace through the end of March 2023, a potential winter surge in COVID-19 infections could result in a peak of around 16,000 hospitalizations and 1,200 deaths per day by March 2023. Under both scenarios modeled, we found an aggressive fall booster vaccination campaign could prevent COVID-19 deaths from exceeding 400 per day.”

The study pointed out that accelerated vaccination campaigns also would be money savers. The researchers found that, stratifying by insurance type, direct medical costs would be reduced by $11 billion for Medicare alone under Scenario 1 and $13 billion under Scenario 2. “An additional $3.5 to $4.5 billion in savings would accrue to Medicaid. Even if the federal government paid all vaccination costs, accelerated campaigns would generate more than $10 billion in net savings from federal programs like Medicare and Medicaid,” the researchers wrote.

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