Vaccines for COVID-19: Effectiveness and value: A summary from the Institute for Clinical and Economic Review’s New England Comparative Effectiveness Public Advisory Council

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, spread around the world in the early months of 2020. In the United States, more than 1.2 million people died of COVID-19. Operation Warp Speed was launched during the first Trump administration in April 2020 to produce a vaccine for COVID-19. The first 2 vaccines developed by Pfizer and BioNTech and by Moderna used messenger RNA (mRNA) technology. Data on these vaccines from November 2020 reported a vaccine effectiveness of 95%. By June 2021, there were more than 300 million doses administered in the United States, which had important impacts on the course of the pandemic. Presently, the US population is not immunologically naive to COVID-19 because of vaccination, prior exposure to SARS-CoV-2, or both. Therefore, the initial data on mRNA and other vaccines from randomized trials provide less-relevant information about vaccination effects in the US population. The 4 COVID-19 vaccines that are currently available in the United States are Spikevax (Moderna), mNEXSPIKE (Moderna), COMIRNATY (Pfizer, BioNTech), and Nuvaxovid (Sanofi, an updated version of the prior Novavax vaccine). The Advisory Committee on Immunization Practices (ACIP), a federal committee that develops recommendations on the use of vaccines in the United States, released recommendations in September 2025 that generally follow the current US Food and Drug Administration prescribing labels. The recommendation for vaccination is for people aged 65 years and older and people aged 6 months to less than 65 years with at least 1 health condition that puts them at increased risk for severe COVID-19. In March 2026, a US District Court Order ruling stayed all votes by the ACIP since June 2025. There are some professional associations and state public health departments that promote guidance in alignment with prior ACIP recommendation for COVID-19 vaccination in all persons aged 6 months or older. The Institute for Clinical and Economic Review (ICER) conducted a systematic literature review and cost-effectiveness analysis to evaluate the clinical and economic impact of vaccines for COVID-19 for the upcoming 2026-2027 season. This report summarizes the findings and highlights the key policy recommendations discussed at the New England Comparative Effectiveness Public Advisory Council (NE CEPAC) public meeting on June 25, 2026. The detailed report is available at https://icer.org/assessment/covid-19-2025/. Copyright © 2026, Academy of Managed Care Pharmacy. All rights reserved.