Assessing the Economic Benefit of Mass COVID-19 Vaccination Program in Iran: A Real-World Modeling Study

Articles in Press

Document Type : Original Article

Authors

1 Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Science, Tehran, Iran

2 Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

4 Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran

5 Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

6 Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

7 Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

8 Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

9 Clinical Tuberculosis and Epidemiology Research Center, National Research Institute for Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

10 Department of Cardiology, Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

11 Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

12 Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Bulent Ecevit University, Zonguldak, Turkey

13 Department of Biotechnology, Islamic Azad University of Medical Science, Tehran, Iran

14 National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran

15 Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background 
The global challenges posed by COVID-19 vaccinations require careful consideration by decision-makers at both the global and national levels, particularly in developing countries. This study aimed to evaluate the health and economic implications of implementing vaccination programs.
 
Methods 
Two scenarios, one involving vaccination and the other without, were analyzed using the Markov Susceptible-Infectious-Recovered (SIR) model. For the vaccination scenario, realworld data, such as age-specific vaccination coverage, hospitalization rates, and mortality, were obtained from the Medical Care Monitoring Center (MCMC) and national COVID-19 registry during the Omicron wave in Iran. For the counterfactual non-vaccination scenario, we relied on model-based assumptions using published literature and expert input to estimate infection rates and clinical outcomes in the absence of vaccination. The Incremental CostEffectiveness Ratio (ICER) of the COVID-19 vaccination program was calculated by comparing the incremental cost per unit of Quality-Adjusted Life Year (QALY) generated to a willingnessto-pay threshold (WTP) equivalent to 1 time the Gross Domestic Product (GDP) per capita, approximately $4091 US. One-way sensitivity analysis was conducted to ensure the reliability of the results.
 
Results 
Overall, 2098495 extra QALYs were generated by vaccination, incurring a total extra cost of $853.78 million. The vaccination program resulted in an average of 0.035 incremental QALYs at an additional cost of $14.08 per person. The average ICER for adult vaccination was $ 406.85 per QALY, indicating that it is a highly cost-effective strategy compared to nonvaccination across all age groups. Vaccinating elderly individuals proved to be the most costeffective approach among all age categories.
 
Conclusion 
The integrated Markov-SIR model used in this study provides valuable insights into both the health and economic impact of the COVID-19 vaccination program in Iran. These findings support the implementation of vaccination strategies and provide a framework for decision-makers to consider when formulating policies. 

Keywords

International Journal of Health Policy and Management

Articles in Press, Accepted Manuscript
Available Online from 06 September 2025

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History

  • Received Date: 10 November 2024
  • Revised Date: 04 August 2025
  • Accepted Date: 31 August 2025
  • First Published Date: 06 September 2025

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