Despite developing reliable and efficient coronavirus disease 2019 vaccines, substantial disparities in immunization rates still exist worldwide.

According to the projections, up to 60% of the population in 91 low- and middle-income countries (LMICs) would benefit from vaccinations in terms of health and donor costs. Researchers simulated an “Omicron-like” variation that was extremely contagious (Re at the model start, 1.7), low-virulent (infection fatality ratio [IFR], 0.32%), and similarly contagious “severe” (IFR, 0.59%) across a 360-day period while taking into consideration the healthcare infrastructure and age composition of the individual countries. Costs comprised vaccine distribution and procurement per person ($12.46/person vaccinated) and vaccine startup ($630 million).

In the Omicron-like scenario, raising vaccination rates to at least 15% in each of the 91 LMICs would avoid 11 million new illnesses and 120,000 deaths for a cost of $0.95 billion, or US$670/year of life saved (YLS). With an incremental cost-effectiveness ratio (ICER) of <US$8,000/YLS, vaccine coverage increased to 60% saving up to 68 million illnesses and 160,000 deaths. Under the more severe variation scenario, ICERs were around <US$4,000/YLS and were essentially unaffected by cost, efficacy, and uptake hypotheses.

Funding increased COVID-19 vaccine distribution in LMICs enhanced health equity, saved hundreds of thousands of lives, and was more cost-effective than other donor-funded international aid initiatives.