Risk and Benefit of mRNA COVID-19 Vaccines for the Omicron Variant by Age, Sex, and Presence of Comorbidity: A Quality-Adjusted Life Years Analysis.

This article evaluates the benefits and risks of monovalent messenger RNA (mRNA) COVID-19 vaccines—specifically BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)—during the period of widespread circulation of the SARS-CoV-2 omicron variant, using quality-adjusted life years (QALYs) as a unified health outcome measure. The study's decision tree model, stratified by age, sex, and comorbidity status, found that the benefits of vaccination in preventing COVID-19 cases, hospitalizations, and deaths substantially outweigh the risks of adverse events such as myocarditis and anaphylaxis across all demographic groups and vaccine doses (primary series, third, and fourth doses). Sensitivity analyses confirmed that benefit-risk ratios remained above one even under varying assumptions about disease incidence, vaccine effectiveness, and adverse event severity. These findings support the recommendation that all eligible individuals stay up to date with COVID-19 vaccinations, acknowledging that the analysis did not include indirect benefits, bivalent vaccines, or populations under five years old.