VACCINATIONS MAKE ECONOMIC SENSE 

Broad COVID-19 vaccination makes economic sense, especially for older adults, study finds

Vaccinating every person over 65 would actually save the U.S. money, while vaccinating all younger adults would be a reasonable investment

Michigan Medicine - University of Michigan

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As the nation gears up for the rollout of an updated COVID-19 vaccine, a new study shows the economic benefits of continued broad vaccination in adults.

In fact, the country would ultimately save more money that it would spend on vaccinating every person over age 65 with a single dose of an updated mRNA vaccine against coronavirus, the study concludes.

That’s because of the power of the vaccine to prevent deaths, hospitalizations, short- and long-term illness and lost productivity such as lost workdays in this age group, the researchers report based on a computer model. The model focused on people without immunocompromising conditions or medications.

Meanwhile, in middle-aged adults from 50 to 64 years old, broad vaccination is a good economic investment, the study concludes. Even vaccinating healthy young adults age 18 to 49 would fall within accepted limits for cost-effectiveness under certain conditions.

The new study, published in JAMA Network Open, comes from a team led by a pair of University of Michigan researchers who have done many vaccine cost-effectiveness studies under contract with the federal Centers for Disease Control and Prevention, or CDC. The paper includes multiple CDC researchers as co-authors.

Lisa Prosser, Ph.D., is the lead author of the new paper and co-leader with David Hutton. Ph.D. of the broader vaccine cost-effectiveness research effort. She is a professor of pediatrics in the U-M Medical School and of health management and policy at the U-M School of Public Health, where Hutton is also a professor.

“We show that a single dose of 2023-2024 mRNA COVID-19 vaccine averted substantial illness and death across age groups, and that this led to economically attractive results for both of the older age groups across wide variations in the parameters of the model,” said Prosser. “However, we also find that a second dose in non-immunocompromised adults under age 64 was not economically favorable, though a second dose in adults over age 65 was.”

She notes that second doses have been recommended for older adults and those of any age with certain conditions for both of the last two COVID-19 vaccination seasons.

The study did not include data from people under the age of 18, because of the lack of data.

In general, the study finds that broad vaccination could prevent 391 hospitalizations and 43 deaths from severe COVID-19 for every 100,000 people over age 65 vaccinated. For those age 18 to 49, those numbers would be lower, with 39 hospitalizations and 1 death prevented for every 100,000 vaccinated.

The number of cases of COVID-19, of any severity, that could be prevented through broad vaccination was about the same for all three age groups, between 7,600 and 8,900 for every 100,000 adults vaccinated.

Prosser notes that declining COVID hospitalization rates may contribute to less favorable economic outcomes in future analyses.

Current COVID-19 situation

CDC data shows that more than 47,000 Americans had COVID-19 listed on their death certificates in 2024, with two-thirds of them having COVID-19 listed as the underlying cause and 34% having it listed as a contributing cause. That is down sharply from the first years of the pandemic, and down substantially from 2023.

Although the vast majority of U.S. adults have received at least one dose of a COVID-19 vaccine since they became available in early 2021, the percentage receiving the updated vaccine in recent years has dropped markedly.

CDC data show that 28% of adults over age 65 taking part in traditional Medicare had received the 2024-2025 vaccine as of this past February. As of April 2025, 23% of adults of all ages told surveyors they had received the 2024-2025 vaccine.

Previous research and underlying model

Earlier this year, Prosser and colleagues published a paper in the journal Vaccine evaluating the cost-effectiveness of the national investment in testing, buying and delivering the first vaccines . In all, they show, this national vaccine strategy carried out in 2020 and 2021 more than paid for itself after just one year.

Even without counting lost productivity, the national COVID-19 vaccine effort saved money for most adult age groups purely by avoiding medical costs, the study concluded. Overall, among all adults over age 40, the nation saved more in avoided medical costs than it spent on the vaccine effort.

The U-M team has presented findings about the cost-effectiveness of several vaccines to meetings of Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practices, which creates recommendations for vaccine use. 

The model used in all of the team’s studies includes everything from the cost of the vaccine itself, to home or lab tests for the virus, to the likelihood of suffering any level of COVD-19 illness or vaccine reaction, to the typical cost of receiving care at any level of illness, to the number of days of work lost for different levels of illness. The researchers included post-COVID conditions, also called Long COVID or PASC for Post-Acute Sequelae of COVID-19.

The model also incorporates data on actual rates and severity of illness, and death rates, for different age groups.

The model uses conservative estimates, so the size of the savings may actually be even larger than the studies report, Prosser notes. For instance, the model does not include the lost productivity of people who took time off work to care for a sick adult family member, patients’ out-of-pocket costs for treatment, or transportation to get to medical care.

Prosser notes that the current CDC recommendation is for everyone over the age of 6 months to get at least one dose of the current COVID-19, though the CDC’s recommendation for children without an immune-compromising condition changed this summer to include shared decisionmaking between the child’s parent/guardian and a health care professional.

For people who are age 65 and older, or immunocompromised because of a health condition or treatment, the CDC recommends a second dose of the current vaccine six months after the first.

Additional authors: In addition to Prosser and Hutton, the new paper’s authors are Angela M. Rose, M.P.H., Kerra Mercon, M.S., Cara B. Janusz, Ph.D. and Acham Gebremariam, M.S. of U-M’s Susan B. Meister Child Health Evaluation and Research Center; and Megan Wallace, Dr.P.H., Andrew J. Leidner, Ph.D.; Fangjun Zhou, Ph.D.; Ismael R. Ortega-Sanchez, Ph.D.; Danielle Moulia, M.P.H.; Ruth Link-Gelles, Ph.D., M.P.H.; Sharon Saydah, Ph.D., M.H.S.; Melisa Shah, M.D., M.P.H.; and Jamison Pike, Ph.D. from CDC.

The study was funded by a CDC grant to U-M (75D30122P15319).

Cost-Effectiveness of 2023-2024 COVID-19 Vaccination in US Adults, JAMA Network Open, doi:10.1001/jamanetworkopen.2025.23688

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Journal

JAMA Network Open

DOI

10.1001/jamanetworkopen.2025.23688 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Cost-Effectiveness of 2023-2024 COVID-19 Vaccination in US Adults

Article Publication Date

7-Aug-2025

 

People who move to more walkable cities do, in fact, walk significantly more

University of Washington

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image: 

This map shows changes in steps between cities of different Walk Scores: Seattle to San Francisco, Dallas to Chicago.

view more 

Credit: Althoff et al./Nature

Study after study shows that walking is very good for those who are able, and generally more is better. A 2023 study found that even 4,000 steps a day improves all-cause mortality risk. (The U.S average is 4,000 to 5,000.) For each 1,000 extra daily steps, risk decreased by 15%.

Walk Scores have been used since 2007 to quantify how quickly people can typically walk to amenities like grocery stores and schools in an area. Cities are assigned scores from 0 to 100; for instance, Seattle’s 74 means it’s “very walkable.” It may seem self-evident that in cities and towns with better scores people tend to walk more. But it’s surprisingly difficult to tease out the cause and effect: Do walkable cities prompt people to take more steps, or do people who want to walk tend to live in more pedestrian-friendly cities?

New research led by the University of Washington provides clear evidence that highly walkable areas lead to significantly more walking. Using data from the Argus step-tracking app, authors compared the steps per day of 5,424 people who moved one or more times among 1,609 cities in the United States. Across all relocations, when the Walk Score rose or fell more than 48 points, average steps increased or decreased by about 1,100 per day. But when people moved between similarly walkable cities, their steps stayed about the same. These findings held across people of different ages, genders and body mass indexes.

For instance, the study tracked 178 people who moved to New York City (Walk Score 89) from different cities with an average score of 48. This group’s average daily steps rose by 1,400 upon moving to New York, from 5,600 to 7,000. Moves from New York to less walkable cities showed the inverse: People averaged 1,400 fewer steps.

The authors published their findings Aug. 13 in Nature.

“Some of our prior work suggested that our physical, built environment makes a big difference in how much we move, but we couldn’t produce particularly strong evidence showing that was the case,” said lead author Tim Althoff, a UW associate professor in the Paul G. Allen School of Computer Science & Engineering. “The large data set we worked with for this new study gave us a unique opportunity to produce this strong, compelling evidence that our built environments do indeed causally impact how much we walk.”

Working with an anonymized data set from 2.1 million people who used the Argus app between 2013 and 2016, the team pulled a subset who had moved and stayed in their new location for at least three months. They normalized for demographics and changes in seasons. They also filtered out days with fewer than 500 steps or more than 50,000, as well as days around moves.

The greatest change in walking the study observed was in the moderate intensity range (100 to 130 steps per minute). Moves that increased Walk Scores more than 49 points were associated with twice as many subjects recording at least 150 minutes of aerobic activity per week, the recommended minimum.

Althoff stressed that while the study provides the strongest evidence to date, no data set is truly representative of the whole U.S. population. For instance, the subjects in this study had all downloaded a step-counting app, which can affect results.

“Our study shows that how much you walk is not just a question of motivation,” Althoff said. “There are many things that affect daily steps, and the built environment is clearly one of them. There's tremendous value to shared public infrastructure that can really make healthy behaviors like walking available to almost everybody, and it's worth investing in that infrastructure.”

Other co-authors on this paper include Boris Ivanovic of NVIDIA Research and Jennifer L. Hicks, Scott L. Delp, Abby C. King and Jure Leskovec of Stanford University.

This research was funded in part by the National Institutes of Health, the National Science Foundation and the Gates Foundation.

For more information, contact Althoff at althoff@cs.washington.edu.

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Journal

Nature

DOI

10.1038/s41586-025-09321-3 

Article Title

Countrywide natural experiment links built environment to physical activity

Article Publication Date

13-Aug-2025

Helping others shown to slow cognitive decline

Regular volunteering or helping others outside the home can reduce the rate of cognitive aging by 15-20%.

University of Texas at Austin

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In the latest evidence that meaningful social connections bolster health, a team from The University of Texas at Austin and University of Massachusetts Boston has found that regular time spent helping outside the home significantly slows cognitive decline in middle-age and older adults.

The new study of more than 30,000 adults in the U.S. looking at individuals over two decades found that the rate of cognitive decline associated with aging fell by 15%-20% for people who formally volunteer their services or who help in more informal ways with neighbors, family or friends outside the home on a regular basis. This cognitive benefit was consistently observed when individuals devoted about two to four hours per week to helping others. The results were reported in the latest edition of the journal Social Science & Medicine and were based on a study funded by the National Institute on Aging at the National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development. 

“Everyday acts of support — whether organized or personal — can have lasting cognitive impact,” said Sae Hwang Han, an assistant professor of human development and family sciences at UT who led the study. “What stood out to me was that the cognitive benefits of helping others weren’t just short-term boosts but cumulative over time with sustained engagement, and these benefits were evident for both formal volunteering and informal helping. And in addition to that, moderate engagement of just two to four hours was consistently linked to robust benefits.”

The study is one of the first to look simultaneously at the impact of volunteering in the formal sense and more informal types of helping, such as assisting neighbors, relatives or friends in need with things like getting to a health appointment, caring for children, lawn work or preparing taxes. While about 1 in 3 older Americans are reported to engage in scheduled or formal volunteering, more than half manage to help other people in their lives regularly in this more informal way.

“Informal helping is sometimes assumed to offer fewer health benefits due to its lack of social recognition,” Han said. But in fact, “It was a pleasant surprise to find that it provides cognitive benefits comparable to formal volunteering.”

The researchers used longitudinal data from the national Health and Retirement Study, examining results from a representative sample of U.S. residents over the age of 51 dating back to 1998. The new study, which controlled for other contributing factors in volunteerism and helping behaviors such as wealth, physical and mental health, and education, found that age-related cognitive decline slowed as people began and sustained helping behaviors. That data suggests that greater gains may be expected in people who make helping behaviors a part of their routine, year over year.

“Conversely, our data show that completely withdrawing from helping is associated with worse cognitive function,” Han said. “This suggests the importance of keeping older adults engaged in some form of helping for as long as possible, with appropriate supports and accommodations in place.”

The paper offers the latest case for bringing a public health lens to discussions about volunteerism, helping and strengthening neighborhood relations, particularly in later life when diseases associated with cognitive decline and impairment, like Alzheimer’s, tend to set in.

Another recent study, also led by Han, found that volunteering buffered the adverse effects of chronic stress on systemic inflammation — a known biological pathway linked to cognitive decline and dementia. The effect was especially pronounced among people with higher levels of inflammation.

Together, the two studies’ findings suggest that helping behaviors can help boost brain health, whether by reducing the physiological wear and tear associated with stress or by fortifying social connections that bring psychological, emotional and cognitive benefits of their own. In the context of an aging society and increasing concerns about loneliness and isolation, the findings also provide an important basis for continuing to involve people in opportunities to help, even once cognitive decline has set in.

“Many older adults in suboptimal health often continue to make valuable contributions to those around them,” Han said, “and they also may be the ones to especially benefit from being provided with opportunities to help.”

Other authors on the study were former UT postdoctoral researcher Shiyang Zhang and Jeffrey Burr of the University of Massachusetts Boston.

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Journal

Social Science & Medicine

DOI

10.1016/j.socscimed.2025.118465 

Method of Research

Meta-analysis

Subject of Research

People

Article Title

Helping behaviors and cognitive function in later life: The impact of dynamic role transitions and dose changes

Article Publication Date

8-Aug-2025

 DEFUND THE POLICE

Youth violence prevention program shown to reduce arrests by up to 75%

Development of a “violence prevention infrastructure” led to sharp declines in arrests for murder, assault and other youth crimes in Denver

University of Colorado at Boulder

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A CU Boulder-led initiative to reduce youth violence in hard-hit Denver neighborhoods was associated with a 75% decline in arrests for murder, assault, robbery and other youth crimes in recent years, new research shows.

“We now have concrete data to show that when communities come together and mobilize, we can prevent youth violence, even in urban settings with a very high burden,” said senior author Beverly Kingston, director of CU’s Center for the Study and Prevention of Violence (CSPV). 

The study, published in the American Journal of Criminal Justice, assesses the efficacy of the Youth Violence Prevention Center - Denver (YVPC-Denver), one of five university-community partnerships established by the Centers for Disease Control after the 1999 Columbine High School shooting. 

The centers have remained one of the only long-term federally funded efforts to address what the agency has termed the “serious public health issue” of youth violence. 

Homicide is the third leading cause of death for youth ages 10 to 24 and the leading cause of death among Black youth, according to the CDC.

A ‘violence prevention infrastructure’ 

In 2011, YVPC-Denver began working with community organizations in the Montbello and Park Hill neighborhoods of Denver to get at the root cause of youth violence plaguing the neighborhoods and come up with and implement solutions. They used a framework called Communities That Care which hinges on two things: science-backed interventions and community involvement.

“It’s all about building a violence prevention infrastructure,” said Kingston. “Just like we have roads and bridges that we put money toward, we need to build an infrastructure that supports violence prevention throughout the life-course.”

In partnership with elementary schools, after-school programs, and faith and sports organizations, the program provided more than 3,000 youth ages 6 to 18 with training on how to handle anger and peacefully resolve conflict.  

The initiative also worked with pediatricians to develop screenings for kids and get them help if they seemed at high risk of committing violence, and provided mini grants to local groups matching positive adult role models with teens.

Perhaps the most visible outgrowth of the program has been the Power of One Campaign, a sweeping youth-led effort in which dozens of youth, known as the Game Changers, use social media, podcasts, neighborhood block parties and more to send a message to their peers that violence is not normal.

One group of Game Changers produced a documentary film “Breaking the Cycle: Stories of Strength and  Survival of Gun Violence.” 

Others recently rolled out an app which connects youth with peers for help handling food insecurity, mental health issues or gang violence. 

“Sometimes the people who are causing the violence are just youth having trouble at home and having a hard time getting the help they need,” said Game Changer Annecya Lawson, who joined the program after a friend was fatally shot her sophomore year in high school. “When these kids see somebody their age, who looks like them, doing stuff for the community, it can have a big impact. They’re more likely to think before they act.”

Crunching the numbers

For the study, CU Boulder researchers analyzed arrest data from the Denver Police Department for the five years prior (2012 – 2016) and five years after (2017 — 2021) Communities that Care was implemented in Park Hill.

They found that arrests fell 75%—from 1,086 per 100,000 people in 2016 to 276 per 100,000 in 2021. Further statistical analyses found that similar communities across the Denver area did not see declines as sharp during the study period. (Collectively, across 74 Denver neighborhoods, youth arrests fell 18% on average).

Montbello, which had implemented Communities that Care several years before Park Hill, maintained stable, lower arrest rates throughout the study period even as they climbed sharply elsewhere amid the COVID-19 pandemic.

This suggests that the infrastructure set up by the program had lasting impacts, said Kingston.

Kingston recently got word that the final year of funding for their current five-year grant cycle is at significant risk of being revoked. Loss of the $1.2 million would jeopardize the existence of the Game Changers and make it impossible for the YVPC – Denver to continue its work.

“Losing this funding would be devastating,” said Kingston. “Not just for Denver but for communities nationwide looking to replicate this success.”

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Journal

American Journal of Criminal Justice

DOI

10.1007/s12103-025-09811-0 

Method of Research

Observational study

Subject of Research

People

Article Title

Effects of the Communities that Care (CTC) Prevention System on Youth Violence Outcomes in Two Violence-Impacted Denver Communities

ADHD medication linked to reduced risk of suicide, drug abuse, transport accidents and criminal behaviour

Findings should help inform clinical practice and the debate on ADHD drug treatment

BMJ Group

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Drug treatment for people with newly diagnosed attention deficit hyperactivity disorder (ADHD) is associated with significantly reduced risks of suicidal behaviours, substance misuse, transport accidents, and criminality, finds a study published by The BMJ today. 

The researchers say this is the first study of its kind to show beneficial effects of ADHD drug treatment on broader clinical outcomes for all ADHD patients and should help inform clinical practice.

ADHD affects around 5% of children and 2.5% of adults worldwide and is associated with adverse outcomes including suicidal behaviours, substance misuse, accidental injuries, transport accidents and criminality.

Although randomised trials have shown that ADHD medication alleviates core symptoms, evidence of its effects on these broader clinical outcomes are more limited.

To address this knowledge gap, researchers drew on data from Swedish national registers (2007-2020) to examine the effects of ADHD drug treatment in 148,581 individuals aged 6-64 years with a new diagnosis of ADHD.

Using a technique called target trial emulation, which applies the design principles of randomised trials to observational data, they assessed first and recurrent events for five outcomes (suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality) over two years after diagnosis.

Of the 148,581 individuals with ADHD (average age 17 years; 41% female), 84,282 (57%) started drug treatment for ADHD, with methylphenidate being the most commonly prescribed (88.4%).

After accounting for factors including age, sex, education level, psychiatric diagnoses and medical history, ADHD medication was associated with reduced rates of a first occurrence of four of the five outcomes: a 17% reduction for suicidal behaviour, 15% for substance misuse, 12% for transport accidents, and 13% for criminality.

The reduction was not statistically significant for a first-time accidental injury (88.5 v 90 per 1000 person years).

However, amongst people with recurrent events, the rate reductions associated with ADHD medication were seen for all five outcomes: a 15% reduction for suicidal attempts, 25% for substance misuse, 4% for accidental injuries, 16% for transport accidents, and 25% for criminality.

Possible explanations include reduced impulsivity, which might lower criminality by curbing aggressive behaviour, and enhanced attention, which might decrease the risk of transport accidents by minimising distractions, suggest the authors.

They acknowledge several limitations, such as being unable to assess data on non-drug treatments or the impact of drug dosage. And while target trial emulation is one of the most rigorous approaches for analysing observational data, they can’t rule out the possibility that other factors, such as ADHD severity, genetic predispositions, and lifestyle factors, may have affected their results, so no definitive causal conclusions can be drawn.

However, this was a large study based on national registry data and findings were similar after further sensitivity analyses, suggesting they are relevant to people with ADHD in real-world clinical settings.

As such, they conclude: “These results provide evidence on the effects of ADHD drug treatment on important health related and social outcomes that should inform clinical practice and the debate on the drug treatment of ADHD.”

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Journal

BMJ

DOI

10.1136/bmj-2024-083658 

Method of Research

Observational study

Subject of Research

People

Article Title

ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: emulation of target trials

Article Publication Date

13-Aug-2025

COI Statement

All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/ and declare: support from the Swedish Research Council for Health, Working Life and Welfare; the Swedish Research Council, ìShizu Matsumuraîs Donation, KI Research Grants, the Swedish Heart-Lung Foundation, the Söderström König Foundation, Fredrik och Ingrid Thurings Stiftelse, the American Foundation for Suicide Prevention, the National Institute for Health and the Care Research, and the European Research Executive Agency; HL has received grants from Shire Pharmaceuticals, personal fees from, and has served as a speaker for, Medici, Shire/Takeda Pharmaceuticals, and Evolan Pharma AB, and sponsorship for a conference on ADHD from Shire/ Takeda Pharmaceuticals and Evolan Pharma AB, all outside the submitted work; SC has received reimbursement for travel and accommodation expenses from the Association for Child and Adolescent Mental Health (ACAMH) in relation to lectures delivered for ACAMH, the Canadian ADHD Alliance Resource, the British Association of Psychopharmacology, and the Healthcare Convention and CCM Group team for educational activity on ADHD; SC has also received honorariums from Medice and serves as chair of the European ADHD Guidelines Group, all outside the submitted work; ZC has received speaker fees from Takeda Pharmaceuticals, outside the submitted work; no other relationships or activities that could appear to have influenced the submitted work.