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USGS2025

Scenario projections of COVID-19 burden in the US, 2024-2025

Importance COVID-19 remains a disease with high burden in the US, prompting continued debate about optimal targets for annual vaccination. Objective To project COVID-19 burden in the US for April 2024 to April 2025 under 6 scenarios of immune escape (20% and 50% per year) and levels of vaccine recommendation (no recommendation, vaccination for individuals at high risk only, vaccination for all eligible groups) and to assess the potential benefit of vaccine recommendations in reducing disease burden. Design, Setting, and Participants For this decision analytical model, the US Scenario Modeling Hub, a collaborative modeling effort, convened 9 teams to provide scenario projections of US COVID-19 hospitalizations and deaths for April 2024 to April 2025, under 6 scenarios combining levels of immune escape and possible vaccine recommendations. Exposure Annually reformulated vaccines were assumed to be 75% effective against hospitalization for variants circulating on June 15, 2024, and available on September 1, 2024. Age- and state-specific coverage was assumed to be as reported in September 2023 to April 2024. Main Outcomes and Measures Ensemble estimates were made for weekly COVID-19 hospitalizations and deaths. Projections are presented for relative and absolute prevented hospitalizations and deaths averted due to vaccination over the April 2024 to April 2025 period. Results For the US population (332 million, with an estimated 58 million aged ≥65 years), COVID-19 was expected to cause 814 000 (95% projection interval [PI], 400 000-1.2 million) hospitalizations and 54 000 (95% PI, 17 000-98 000) deaths for April 2024 to April 2025, comparable in magnitude to the prior year. Vaccination of high-risk groups only was projected to reduce hospitalizations (compared to no vaccination recommendation) by 76 000 (95% CI, 34 000-118 000) and deaths by 7000 (95% CI, 3000-11 000) across both immune escape scenarios. Compared with vaccinating high-risk groups only, a universal vaccine recommendation was projected to provide direct and indirect benefits, further preventing 11 000 hospitalizations and 1000 deaths in those aged 65 years and older. Conclusions and Relevance In this decision analytical modeling study of COVID-19 burden in the US in 2024 to 2025, ensemble projections suggested that although vaccinating high-risk groups had substantial benefits in reducing disease burden, maintaining the vaccine recommendation for all individuals had the potential to save thousands more lives. Despite divergence of projections from observed disease trends in 2024 to 2025—possibly driven by variant emergence patterns and immune escape—averted COVID-19 burden due to vaccination was robust across immune escape scenarios, emphasizing the substantial benefit of broader vaccine availability for all individuals.

JAMA Network Open↗

USGS2024

Potential impact of annual vaccination with reformulated COVID-19 vaccines: Lessons from the US COVID-19 scenario modeling hub

Background Coronavirus Disease 2019 (COVID-19) continues to cause significant hospitalizations and deaths in the United States. Its continued burden and the impact of annually reformulated vaccines remain unclear. Here, we present projections of COVID-19 hospitalizations and deaths in the United States for the next 2 years under 2 plausible assumptions about immune escape (20% per year and 50% per year) and 3 possible CDC recommendations for the use of annually reformulated vaccines (no recommendation, vaccination for those aged 65 years and over, vaccination for all eligible age groups based on FDA approval). Methods and findings The COVID-19 Scenario Modeling Hub solicited projections of COVID-19 hospitalization and deaths between April 15, 2023 and April 15, 2025 under 6 scenarios representing the intersection of considered levels of immune escape and vaccination. Annually reformulated vaccines are assumed to be 65% effective against symptomatic infection with strains circulating on June 15 of each year and to become available on September 1. Age- and state-specific coverage in recommended groups was assumed to match that seen for the first (fall 2021) COVID-19 booster. State and national projections from 8 modeling teams were ensembled to produce projections for each scenario and expected reductions in disease outcomes due to vaccination over the projection period. From April 15, 2023 to April 15, 2025, COVID-19 is projected to cause annual epidemics peaking November to January. In the most pessimistic scenario (high immune escape, no vaccination recommendation), we project 2.1 million (90% projection interval (PI) [1,438,000, 4,270,000]) hospitalizations and 209,000 (90% PI [139,000, 461,000]) deaths, exceeding pre-pandemic mortality of influenza and pneumonia. In high immune escape scenarios, vaccination of those aged 65+ results in 230,000 (95% confidence interval (CI) [104,000, 355,000]) fewer hospitalizations and 33,000 (95% CI [12,000, 54,000]) fewer deaths, while vaccination of all eligible individuals results in 431,000 (95% CI: 264,000–598,000) fewer hospitalizations and 49,000 (95% CI [29,000, 69,000]) fewer deaths. Conclusions COVID-19 is projected to be a significant public health threat over the coming 2 years. Broad vaccination has the potential to substantially reduce the burden of this disease, saving tens of thousands of lives each year.

PLOS Medicine↗