• Chad R Wells, Abhishek Pandey, Seyed M Moghadas, Meagan C Fitzpatrick, Burton H Singer, and Alison P Galvani.
• Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, Connecticut (C.R.W., A.P., A.P.G.).
• Ann. Intern. Med. 2024 May 1; 177 (5): 609617609-617.

BackgroundThe U.S. Food and Drug Administration has proposed administering annual SARS-CoV-2 vaccines.ObjectiveTo evaluate the effectiveness of an annual SARS-CoV-2 vaccination campaign, quantify the health and economic benefits of a second dose provided to children younger than 2 years and adults aged 50 years or older, and optimize the timing of a second dose.DesignAn age-structured dynamic transmission model.SettingUnited States.ParticipantsA synthetic population reflecting demographics and contact patterns in the United States.InterventionVaccination against SARS-CoV-2 with age-specific uptake similar to that of influenza vaccination.MeasurementsIncidence, hospitalizations, deaths, and direct health care cost.ResultsThe optimal timing between the first and second dose delivered to children younger than 2 years and adults aged 50 years or older in an annual vaccination campaign was estimated to be 5 months. In direct comparison with a single-dose campaign, a second booster dose results in 123 869 fewer hospitalizations (95% uncertainty interval [UI], 121 994 to 125 742 fewer hospitalizations) and 5524 fewer deaths (95% UI, 5434 to 5613 fewer deaths), averting $3.63 billion (95% UI, $3.57 billion to $3.69 billion) in costs over a single year.LimitationsPopulation immunity is subject to degrees of immune evasion for emerging SARS-CoV-2 variants. The model was implemented in the absence of nonpharmaceutical interventions and preexisting vaccine-acquired immunity.ConclusionThe direct health care costs of SARS-CoV-2, particularly among adults aged 50 years or older, would be substantially reduced by administering a second dose 5 months after the initial dose.Primary Funding SourceNatural Sciences and Engineering Research Council of Canada, Notsew Orm Sands Foundation, National Institutes of Health, Centers for Disease Control and Prevention, and National Science Foundation.

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