Rolling out a booster vaccination campaign would benefit Indonesia by US$381 billion in the next year according to the latest Imperial report.

This is through reducing the need for economically costly pandemic mitigation measures, according to the latest report by the Imperial College COVID-19 Response Team.

Most of the population has so far only received two vaccine doses, if any, typically using the Sinovac vaccine. Spending an estimated USD$30 per Moderna booster is expected to save at least USD$2,000 (1,400-3,400) by averting deaths, keeping children and young people in education and keeping businesses open. This translates to an expenditure of US$5.6 billion for 187 million vaccines with a total expected savings of USD$381 billion (USD$260-640 billion). The report describes a variation of these estimates depending on valuation of lives and education.

"Equitable distribution of vaccines is essential to halt widening inequalities - and the costs they avert in the long term far outweigh what the vaccines themselves will cost." Dr Rob Johnson

In mitigating the pandemic, countries face an agonizing trade-off between deaths and closures of non-essential economic activity and in-person education. Vaccinations are one of the key interventions to address this trade-off. They not only reduce deaths, but also the need for policy makers to implement socially damaging and economically costly pandemic mitigation measures.

This study estimates the socio-economic gains of vaccinations in terms of gross domestic product (GDP), deaths averted, and person-years of education gained under alternative vaccination scenarios and mitigation strategies. To do so, researchers use an integrated economic-epidemiological model (DAEDALUS). Considering vaccine effectiveness and waning, three scenarios against a baseline of first and second vaccinations are considered: no boosters, 40% and 80% coverage within the target group of adolescents, adults, and those over 65 eligible for a booster dose.

The total expected socio-economic gain of the booster campaign is USD $381 billion (95% confidence interval USD $260-$640). This comprises 19 million years of in-person education (19 million school-aged children in education for one year), $81 billion in economic activity, and 300,000 life-years (or averting 14,000 deaths).

The central estimate in the report is that the social benefit of each booster dose is USD $2,000 (95% confidence interval $1,400-$3,400). The choices for scenarios for vaccine rollout and valuations for life years and education affect the cost calculations, and additional results are presented in the report.

The researchers demonstrate that the majority of benefits of vaccination manifest in the reduced need for costly mitigation, rather than averted deaths. They call for a comprehensive modelling of the benefits of vaccinations focusing not only on health impacts, but also on economic and social impacts.

Dr Rob Johnson from Imperial College London said: “The cost of the pandemic worldwide has been enormous. Many countries are still paying high prices in school and business closures to curb hospitalisations and deaths: lost education in particular will have life-long impacts for a whole generation. Equitable distribution of vaccines is essential to halt widening inequalities - and the costs they avert in the long term far outweigh what the vaccines themselves will cost.”

Prof Katharina Hauck from Imperial College London said: “We were surprised how high the societal benefits of vaccines are for an emerging economy. We knew that vaccines prevent deaths, and the need for damaging business and school closures. But there were no monetary estimates of these benefits.”

Bimandra Djaafara from Imperial College London said: “Business and school closures throughout the COVID-19 pandemic have become constant challenges for many Indonesians. We estimated that the national booster vaccination campaigns could help society gradually go back to living their life ‘normally.”

The work is presented in the latest report from the WHO Collaborating Centre for Infectious Disease Modelling within the MRC Centre for Global Infectious Disease Analysis, Jameel Institute, Imperial College London.

Since the emergence of the new coronavirus (COVID-19) in December 2019, the Imperial College COVID-19 Response Team has adopted a policy of immediately sharing research findings on the developing pandemic.