THANKS, DARPA!:

Lewis: COVID vaccines cost billions to develop and deliver. But for at least one big city that used them, they had an incredible rate of financial return. 

Fischman: We usually talk about vaccines saving lives. But in New York City, hit hard by the pandemic early on, they saved the town from a gigantic economic hole too, Tanya. Vaccines saved the city about $28 BILLION dollars, which is what it would have lost without vaccines. Or, as you said, every dollar spent on shots saved ten dollars that would have been spent without shots.

Lewis: Where did the savings come from?

Fischman: A few different places. Long hospitalizations that weren't needed, emergency room visits avoided, and workers who stayed healthy instead of calling in sick.

Lewis: Hmm. But how did they know about things that didn't happen? And how can you count those things?

Fischman: I wondered about that too. It turns out scientists do know enough to build a model of events without vaccines. We know how effective the shots are at keeping people out of the hospital, and we have estimates of how many people in New York were infected. So from that scientists can figure out how many infected New Yorkers would have been hospitalized if vaccines didn't exist. And there's data on numbers of unvaccinated people who turn up in emergency rooms versus vaccinated people. 

Lewis: That makes sense. So what were the actual dollar figures?

Fischman: The direct costs of COVID-related healthcare--hospitals and suchlike--were about 7 and a half billion dollars with vaccines. Without them, the cost jumped to 33 billion.

Costs like the value of lost workdays came to almost 2 billion dollars with vaccination. Without it, the dollars lost due to lost productivity more than doubled, to over 4 billion, the researchers reported in a recent issue of the journal JAMA Network Open.

Lewis: But the vaccines themselves cost a lot for city and federal governments to get and distribute. To be fair, that has to be accounted for.

Fischman: It was almost 5 billion dollars, including money the feds gave to the city for running the vaccine campaign and buying the actual shots. 

The math of these calculations gets complicated, but at a basic level, New York spent that 5 billion and, as a result, kept at least 28 billion. Also business or school shutdowns would have been even longer, and cost even more money, if vaccines weren't around. 

So yes, vaccines save millions of lives, which are hard to put a value on. But they are also an incredibly strong return on investment.

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