People vaccinated against COVID in Germany in 2023 experienced reduced hospitalization rates, fewer long-COVID diagnoses, and lower all-cause mortality than those who weren’t vaccinated, according to a new study published in Eurosurveillance. These clinical benefits translated to significant reductions in health care costs and lost productivity due to sick leave. 

For the study, researchers led by a team from BioNTech, which codeveloped COVID-19 vaccines with Pfizer, analyzed health insurance data for roughly 146,000 people, half of whom were vaccinated, from September 2022 through March 2024 to assess the impact of COVID vaccination on clinical and economic outcomes.

Reduced odds of long COVID

The findings suggest that vaccination was associated with a meaningful reduction in severe outcomes. COVID-related hospitalizations were less than half as common among vaccinated participants, with 0.30 hospitalizations per 100 people per year, compared with 0.75 among those who were unvaccinated. Most of the COVID-related hospitalizations were due to pneumonia. 

Vaccinated participants were also less likely to receive a long-COVID diagnosis. A German national public health organization, the Robert Koch Institut, estimates that 5% to 10% of people infected with SARS-CoV-2 develop long COVID. 

The hospitalization rate for respiratory infections was also lower among vaccinated people. There were 2.8 hospitalizations per 100 people per year in the vaccinated group, compared with 3.6 in the unvaccinated group. A similar pattern was seen for cardiovascular disease. Hospitalizations for heart-related conditions occurred at a rate of 8.9 per 100 people per year among vaccinated people, compared with 11.2 in their unvaccinated counterparts.

During the four-month follow-up period, vaccinated people were less likely than their unvaccinated peers to die from any cause. There were 4.5 deaths per 100 people per year in the vaccinated group, compared with 6.0 deaths per 100 in the unvaccinated group.

Lower hospital costs, fewer sick days

The clinical benefits associated with vaccination led to measurable reductions in health care costs, according to the data. On average, vaccinated participants incurred about €21 ($25)  per person per year in COVID-related hospital costs, compared with about €64 ($75) for unvaccinated participants.

Over the follow-up period, those savings added up to just over 1 million fewer Euros spent on COVID-related hospital care among vaccinated people. Preventing illness also helped limit indirect costs such as lost productivity due to missed work. 

“Beyond direct health benefits, vaccinated working-age individuals incurred fewer COVID-19– and respiratory-related sick leave days, resulting in an estimated EUR 1.3 million [$1.5 million] reduction in indirect costs due to absence from work,” the researchers write. 

“The relevance of these findings is pertinent, as sick leave days resulting from respiratory infections represented the most common reason for absence from work in Germany in 2024,” they added. “This highlights the broader economic relevance of vaccination from both healthcare payer and societal perspectives.”

The data also showed that both the clinical and economic benefits were greater among older adults and those with underlying conditions—two groups that face a higher risk of severe disease. 

Importance of improving vaccine uptake

The study adds to a growing body of evidence that seasonal COVID vaccination can play a role in reducing disease burden and associated costs, and it highlights the value of increasing vaccination coverage at a time when US public health leaders have downplayed its importance. 

“These findings highlight the clinical and economic benefits of seasonal COVID-19 vaccination, particularly for individuals at increased risk of severe disease and for working-age populations with high social contact,” they write. “The results underscore the importance of improving uptake and support continued implementation of national vaccination recommendations.”