US Scenario Modeling Hub, a collaborative modeling effort of 17 academic research institutions, reports a universal COVID-19 vaccination recommendation could avert thousands more US hospitalizations and deaths than a high-risk-only strategy.
COVID-19 remains a substantial current public health concern in the US, with higher in-hospital mortality than seasonal influenza during fall-winter 2023–2024.
The Advisory Committee on Immunization Practices (ACIP) sets vaccine use guidance and has traditionally been made up of medical and public health experts within the U.S. Centers for Disease Control and Prevention (CDC). The committee is tasked with framing evidence-based recommendations for the use of vaccines that are effective in controlling diseases.
Recently, the committee has undergone a complete turnover of members, removing seasoned experts in favor of political appointments that include a psychiatrist and several individuals that claim vaccines cause disease. Gone are family physicians and pediatric infectious disease specialists, epidemiologists, geriatric medicine specialists, obstetricians and anyone with experience as a public health implementer.
Scenario modeling offers a way to compare potential future outcomes of ACIP decisions and inform policy for public health groups that will no longer rely on ACIP recommendations.
In the study, “Scenario Projections of COVID-19 Burden in the US, 2024-2025,” published in JAMA Network Open, researchers used a decision-analytical model to project national hospitalizations and deaths from April 2024 to April 2025 and to assess the potential benefit of annual vaccine recommendations.
Nine independent teams produced projections under six scenarios that combined two immune escape rates, 20% and 50% per year. An immune escape rate is the annual reduction in protection against infection that occurs as new SARS-CoV-2 variants evolve. Projections covered the United States population of 332 million with an estimated 58 million aged 65 years.
Three vaccine recommendation strategies were tested. No recommendation, recommendation for high-risk groups only, or recommendation for all eligible individuals. Annually reformulated vaccines were assumed to match variants circulating on June 15, 2024, to be available on September 1, 2024, and to be 75% effective against hospitalization at the time of release.
Teams calibrated their models to weekly hospitalizations and deaths reported by the National Healthcare Safety Network and the National Center for Health Statistics.
In the worst case scenario, defined by high immune escape with no vaccine recommendation, projections reached 931,000 hospitalizations with a 95% projection interval of 0.5 to 1.3 million and 62,000 deaths with a 95% projection interval of 18,000 to 115,000.
In the best case defined by low immune escape with a universal recommendation, the ensemble projected 550,000 hospitalizations with a 95% projection interval of 296,000 to 832,000 and 42,000 deaths with a 95% projection interval of 13,000 to 72,000.
Severe outcomes clustered in older populations. Across scenarios, adults aged 65 years and older accounted for 51% to 62% of hospitalizations and 84% to 87% of deaths.
Vaccination of high-risk groups was only projected to avert 11% of hospitalizations under low immune escape and 8% under high escape, along with 13% and 10% of deaths. A universal recommendation increased the effect with 15% fewer hospitalizations under low immune escape and 11% fewer under high, with 16% and 13% fewer deaths.
Under high immune escape, a high-risk-only strategy averted 76,000 hospitalizations with a 95% CI of 34,000 to 118,000 and 7,000 deaths with a 95% CI of 3,000 to 11,000. Expanding to a universal recommendation prevented 104,000 hospitalizations with a 95% CI of 55,000 to 153,000 and 9,000 deaths with a 95% CI of 4,000 to 14,000.
Additional indirect benefits accrued to older adults under a universal strategy. Compared with high-risk-only vaccination, universal recommendations prevented about 11,000 more hospitalizations and 1,000 more deaths in those aged 65 years and older.
Observed national patterns diverged in timing from projections. A marked summer 2024 wave was followed by a smaller peak in January 2025, while projections anticipated the heaviest burden from late December 2024 to mid January 2025. Ensemble coverage for weekly deaths remained strong, with 95% intervals closely matching observed values.
Authors conclude that vaccines remain a critical tool to limit COVID-19 burden in 2024–2025, with universal recommendations offering added direct and indirect protection and the potential to save thousands more lives, including among older adults.
Written for you by our author Justin Jackson, edited by Sadie Harley, and fact-checked and reviewed by Robert Egan—this article is the result of careful human work. We rely on readers like you to keep independent science journalism alive. If this reporting matters to you, please consider a donation (especially monthly). You’ll get an ad-free account as a thank-you.
More information: Sara L. Loo et al, Scenario Projections of COVID-19 Burden in the US, 2024-2025, JAMA Network Open (2025). DOI: 10.1001/jamanetworkopen.2025.32469
News
NanoMedical Brain/Cloud Interface – Explorations and Implications. A new book from Frank Boehm
New book from Frank Boehm, NanoappsMedical Inc Founder: This book explores the future hypothetical possibility that the cerebral cortex of the human brain might be seamlessly, safely, and securely connected with the Cloud via [...]
How lipid nanoparticles carrying vaccines release their cargo
A study from FAU has shown that lipid nanoparticles restructure their membrane significantly after being absorbed into a cell and ending up in an acidic environment. Vaccines and other medicines are often packed in [...]
New book from NanoappsMedical Inc – Molecular Manufacturing: The Future of Nanomedicine
This book explores the revolutionary potential of atomically precise manufacturing technologies to transform global healthcare, as well as practically every other sector across society. This forward-thinking volume examines how envisaged Factory@Home systems might enable the cost-effective [...]
A Virus Designed in the Lab Could Help Defeat Antibiotic Resistance
Scientists can now design bacteria-killing viruses from DNA, opening a faster path to fighting superbugs. Bacteriophages have been used as treatments for bacterial infections for more than a century. Interest in these viruses is rising [...]
Sleep Deprivation Triggers a Strange Brain Cleanup
When you don’t sleep enough, your brain may clean itself at the exact moment you need it to think. Most people recognize the sensation. After a night of inadequate sleep, staying focused becomes harder [...]
Lab-grown corticospinal neurons offer new models for ALS and spinal injuries
Researchers have developed a way to grow a highly specialized subset of brain nerve cells that are involved in motor neuron disease and damaged in spinal injuries. Their study, published today in eLife as the final [...]
Urgent warning over deadly ‘brain swelling’ virus amid fears it could spread globally
Airports across Asia have been put on high alert after India confirmed two cases of the deadly Nipah virus in the state of West Bengal over the past month. Thailand, Nepal and Vietnam are among the [...]
This Vaccine Stops Bird Flu Before It Reaches the Lungs
A new nasal spray vaccine could stop bird flu at the door — blocking infection, reducing spread, and helping head off the next pandemic. Since first appearing in the United States in 2014, H5N1 [...]
These two viruses may become the next public health threats, scientists say
Two emerging pathogens with animal origins—influenza D virus and canine coronavirus—have so far been quietly flying under the radar, but researchers warn conditions are ripe for the viruses to spread more widely among humans. [...]
COVID-19 viral fragments shown to target and kill specific immune cells
COVID-19 viral fragments shown to target and kill specific immune cells in UCLA-led study Clues about extreme cases and omicron’s effects come from a cross-disciplinary international research team New research shows that after the [...]
Smaller Than a Grain of Salt: Engineers Create the World’s Tiniest Wireless Brain Implant
A salt-grain-sized neural implant can record and transmit brain activity wirelessly for extended periods. Researchers at Cornell University, working with collaborators, have created an extremely small neural implant that can sit on a grain of [...]
Scientists Develop a New Way To See Inside the Human Body Using 3D Color Imaging
A newly developed imaging method blends ultrasound and photoacoustics to capture both tissue structure and blood-vessel function in 3D. By blending two powerful imaging methods, researchers from Caltech and USC have developed a new way to [...]
Brain waves could help paralyzed patients move again
People with spinal cord injuries often lose the ability to move their arms or legs. In many cases, the nerves in the limbs remain healthy, and the brain continues to function normally. The loss of [...]
Scientists Discover a New “Cleanup Hub” Inside the Human Brain
A newly identified lymphatic drainage pathway along the middle meningeal artery reveals how the human brain clears waste. How does the brain clear away waste? This task is handled by the brain’s lymphatic drainage [...]
New Drug Slashes Dangerous Blood Fats by Nearly 40% in First Human Trial
Scientists have found a way to fine-tune a central fat-control pathway in the liver, reducing harmful blood triglycerides while preserving beneficial cholesterol functions. When we eat, the body turns surplus calories into molecules called [...]
A Simple Brain Scan May Help Restore Movement After Paralysis
A brain cap and smart algorithms may one day help paralyzed patients turn thought into movement—no surgery required. People with spinal cord injuries often experience partial or complete loss of movement in their arms [...]
