Health, economic, and equity impact of a COVID-19 mobile vaccine clinic program in US: a cost-effectiveness analysis

Background: Mobile vaccine clinic (MVC) programs represent a significant public health investment, rigorous data on their health, economic, and equity impacts are needed to guide policy for future immunization efforts. We estimated the health and economic outcomes of the State of Utah's 1-year COVID-19 MVC program, stratified by Hispanic and non-Hispanic populations. Methods: We used a decision-analytic model combining a susceptible-infected-removed (SIR) model with a decision tree to simulate 3.23 million Utah residents over one year (April 1, 2021, to March 31, 2022). We compared an MVC program scenario with a no-MVC program scenario. Health outcomes included vaccinations, infections, hospitalizations, intensive care unit (ICU) admissions, and deaths. Economic outcomes included direct and total costs (in 2021 US dollars) and return on investment (ROI) from healthcare sector and societal perspectives. All outcomes were stratified by Hispanic and non-Hispanic populations. Findings: In this economic evaluation of 3.23 million Utah residents, the 1-year MVC program vaccinated 29,420 additional people, preventing an estimated 41,503 infections, 923 hospitalizations, 240 ICU admissions, and 253 deaths. The MVC program was cost-saving compared with no MVC program from both healthcare sector (net savings, $51.71 million) and societal (net savings, $71.30 million) perspectives. Every $1 invested in the MVC program yielded $9.70 in societal savings. Prevented adverse outcomes per 100,000 persons were 3.2-6.0 times higher in the Hispanic versus non-Hispanic population. Interpretation: The MVC program was a cost-saving and equity-enhancing public health strategy. These findings support investment in MVC programs for future vaccination campaigns. Funding: This study was funded by cooperative agreement CDC-RFA-FT-23-0069 from the CDC's Center for Forecasting and Outbreak Analytics.