Bangladesh Journal of Pharmacology Volume: 17; Number 1; Year 2022 Cite this article as: Sookaromdee P, Wiwanitkit V. Cost-effectiveness analysis of intradermal versus classical intramuscular COVID-19 vaccine administration. Bangladesh J Pharmacol. 2022; 17: 9-10. Cost-effectiveness analysis of intradermal versus classical intramuscular COVID-19 vaccine administration Sir, COVID-19 remains a global crisis with no effective disease control (Hsia, 2020). The best chance for catas- trophe management is vaccination (Karim, 2020). Immunization against COVID-19 is now widely recog- nized as an effective primary COVID-19 prevention method. COVID-19 immunization has been proven to be effective in the prevention of COVID-19 (Karim, 2020; Wang et al., 2020). Typically, two vaccination doses are administered via intramuscular injection. By administering COVID-19 differently, many scientists suggest techniques for decreasing the risk and resolving the problem of insufficient COVID-19 immunization supply (Schweiger, 2021 ; Schnyder et al., 2022). Intradermal administration was therefore offered as a good technique to provide reciprocal doses while redu- cing vaccine cost and quantity necessary (Intapiboon et al., 2021). Indeed, the immunogenicity and efficacy of fractional intradermal vaccination in comparison to full dose immunisation has been explored and validated for several pathogens, including influenza virus, rabies virus, poliovirus, hepatitis B virus, and hepatitis A virus (Intapiboon et al., 2021). Alternative vaccination administration's cost and effectiveness are both important considerations to consider. In this study, the authors compare the cost- effectiveness of alternate intradermal COVID-19 vaccine administration to regular intramuscular COVID -19 vaccine administration. Only mRNA COVID-19 vaccine delivery is the subject of this study. The traditional two-dose vaccine is mostly conditioned. Intramuscular injection and intradermal injection were the two vaccine administration routes evaluated by the authors. According to a recent publication (Intapiboon et al., 2021), one-fifth of the usual intramuscular mRNA vaccine dosage is adminis- tered intradermally for intradermal vaccine administra- tion. In this work cost is the unit cost of vaccine administration in our scenario (referencing to local data, https://covid-19.kapook.com/view241253.html). According to publicly available information, the cost of one dose of COVID-19 provided by intramuscular injection is 34.32 Euro. A direct overall cost comparison for intradermal versus standard intramuscular COVID- 19 vaccination is undertaken for a cost comparison. The authors used a cost-effectiveness analysis to examine the cost and effectiveness of the new COVID19 vaccinations, which will be available to the public soon. As previously stated, the cost is derived directly from public data. In terms of effectiveness, the prior comparison study's claimed vaccine effectiveness is referred to. At 1 month following COVID-19 vaccination, the effectiveness is assigned as SARS-CoV- 2 Anti-RBD antibody response compared to no immunization and is displayed in times. The effectiveness of intradermal versus standard intramuscular COVID-19 vaccine administration is equal to 38 and 75 times, respectively, according to the referencing study (Intapiboon et al., 2021). The primary data for investigation is publicly available data, which has already been described. For analysis, the reported proposed vaccination price is assigned to cost, while the indicated vaccine efficacy is assigned to effectiveness. The cost per effectiveness of each COVID19 vaccine administration is calculated, and the cost-effectiveness value of vaccine administration is compared. The cost per unit effectiveness of employing intra- dermal COVID-19 vaccine injection is lower than that of intramuscular immunization, according to cost- effectiveness analysis (Table I). Instead of intramuscular immunization, intradermal COVID-19 vaccine injection resulted in a 2.5-fold reduction in necessary cost per unit effectiveness. Intradermal immunization is a viable alternative to the usual intramuscular COVID-19 vaccine, according to A Journal of the Bangladesh Pharmacological Society (BDPS) Bangladesh J Pharmacol 2022; 17: 9-10 Journal homepage: www.banglajol.info; www.bdpsjournal.org Abstracted/indexed in Academic Search Complete, Agroforestry Abstracts, Asia Journals Online, Bangladesh Journals Online, Biological Abstracts, BIOSIS Previews, CAB Abstracts, Current Abstracts, Directory of Open Access Journals, EMBASE/Excerpta Medica, Global Health, Google Scholar, HINARI (WHO), International Pharmaceutical Abstracts, Open J-gate, Science Citation Index Expanded, SCOPUS and Social Sciences Citation Index ISSN: 1991-0088; DOI: 10.3329/bjp.v17i1.57593 Letter to the Editor This work is licensed under a Creative Commons Attribution 4.0 International License. You are free to copy, distribute and perform the work. You must attribute the work in the manner specified by the author or licensor Table I Cost-effectiveness analysis of COVID-19 vaccine administration Vaccination methods Cost (Euro) Times Cost-effectiveness value (Euro) Intramuscular 34.32 75 0.458 Intradermal 6.86 38 0.181 current research, and may even be superior in terms of cost-effectiveness. Pathum Sookaromdee1 and Viroj Wiwanitkit2 1Private Academic Consultant Center, Bangkok, Thailand; 2Department of Community Medicine, Dr. D. Y. Patil University, Pune, India. Corresponding author: Email: pathumsook@gmail.com References Hsia W. Emerging new coronavirus infection in Wuhan, China: Situation in early 2020. Case Study Case Rep. 2020; 10: 8-9. Intapiboon P, Seepathomnarong P, Ongarj J, Surasombat- pattana S, Uppanisakorn S, Mahasirimongkol S, Sawaeng- dee W, Phumiamorn S, Sapsutthipas S, Sangsupawanich P, Chusri S, Pinpathomrat N. Immunogenicity and safety of an intradermal BNT162b2 mRNA vaccine booster after two doses of inactivated SARS-CoV-2 vaccine in healthy population. Vaccines (Basel) 2021. 9: 1375. Karim SA. COVID‑19 vaccine affordability and accessibility. Lancet 2020; 396: 238. Schnyder JL, de Jong HK, Grobusch MP. Intradermal immunization: A dose-sparing strategy to combat global shortages of severe acute respiratory syndrome coronavirus 2 vaccines? Clin Microbiol Infect. 2022; 28: 6-8. Schweiger M. Intradermal covid-19 vaccination could solve supply problems. BMJ. 2021; 374: 1980. Wang J, Peng Y, Xu H, Cui Z, Williams RO 3rd. The COVID- 19 vaccine race: Challenges and opportunities in vaccine formulation. AAPS Pharm Sci Tech. 2020; 21: 225. 10 Bangladesh J Pharmacol 2022; 17: 9-10