The Department of Defense (DoD) faced challenges during the COVID-19 pandemic, including the implementation of vaccine policies to maintain operational readiness and troop health. This retrospective, ex ante analysis examines the cost-benefit implications of the COVID-19 vaccine mandate implemented by the DoD in August 2021, following the full FDA licensing of the Pfizer-BioNTech Comirnaty vaccine.

The mandate aimed to enhance force health protection against the virus, yet resulted in significant operational and policy repercussions, including over 8,400 servicemembers choosing non-compliance and discharge, followed by Congressional repeal of the policy in December 2022.

Always 2020

A Cost-Benefit Analysis of the DoD's COVID-19 Vaccine Mandate

Mary Avriette

ResearchPublished Sep 23, 2024

The Department of Defense (DoD) faced challenges during the COVID-19 pandemic, including the implementation of vaccine policies to maintain operational readiness and troop health. This retrospective, ex ante analysis examines the cost-benefit implications of the COVID-19 vaccine mandate implemented by the DoD in August 2021, following the full FDA licensing of the Pfizer-BioNTech Comirnaty vaccine. 

The mandate aimed to enhance force health protection against the virus, yet resulted in significant operational and policy repercussions, including over 8,400 servicemembers choosing non-compliance and discharge, followed by Congressional repeal of the policy in December 2022.

Key Finding

  • The analysis uses a multifaceted approach to determine costs of vaccine procurement, adverse event treatment, and the productivity losses of non-compliant troops. Costs over one year are projected at $774 million. Benefits are estimated using epidemiological models to project reductions in infection, hospitalization, and mortality rates, alongside from sustained operational readiness. The total benefits of the vaccine policy are projected at $2.3 billion, or a net policy benefit of $1.6 billion.

Recommendation

  • Future policymakers may possibly avoid universal vaccine requirements through enhanced voluntary vaccination campaigns. In the event vaccination requirements become necessary, this analysis recommends to tailor vaccination policies by data and risk, streamline policy implementation, develop a formal process to balance public health with personnel retention, and conduct studies on vaccine refusal behavior. These recommendations aim to enhance the effectiveness of military vaccination policies while mitigating associated costs, ensuring military readiness and health in future public health emergencies.

Author Statement

To evaluate the costs and benefits of implementing a COVID-19 vaccine mandate within the military and provide insights for future vaccine policy decisions during public health emergencies.

Topics

Document Details

Citation

RAND Style Manual
Avriette, Mary, Always 2020: A Cost-Benefit Analysis of the DoD's COVID-19 Vaccine Mandate, RAND Corporation, RGSD-A3550-1, 2024. As of September 23, 2024: https://www.rand.org/pubs/rgs_dissertations/RGSDA3550-1.html
Chicago Manual of Style
Avriette, Mary, Always 2020: A Cost-Benefit Analysis of the DoD's COVID-19 Vaccine Mandate. Santa Monica, CA: RAND Corporation, 2024. https://www.rand.org/pubs/rgs_dissertations/RGSDA3550-1.html.
BibTeX RIS

Research conducted by

This document was submitted as a dissertation in July 2024 in partial fulfillment of the requirements of the doctoral degree in Public Policy Analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Angel O'Mahony (chair), John Grabenstein, and Brittany Clayton.

This publication is part of the RAND dissertation series. Pardee RAND dissertations are produced by graduate fellows of the Pardee RAND Graduate School, the world's leading producer of Ph.D.'s in policy analysis. The dissertations are supervised, reviewed, and approved by a Pardee RAND faculty committee overseeing each dissertation.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.