ArticleBMC medicine2018
Cost-effectiveness of vaccination of immunocompetent older adults against herpes zoster in the Netherlands: a comparison between the adjuvanted subunit and live-attenuated vaccines.
Article in BMC medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- The incidence rate of herpes zoster in inflammatory bowel disease: A meta-analysis of cohort studies.Medicine · 2021Pooled it
- Informing decisions in light of parameter uncertainty - an economic evaluation of the adjuvanted recombinant herpes zoster vaccine in Sweden.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Cost Effectiveness of Recombinant Zoster Vaccine and Live-Attenuated Vaccine Against Herpes Zoster for Adults Aged 50 and Over in China.PharmacoEconomics - open · 2025Article
- Cost-effectiveness analysis of herpes zoster vaccination for adults aged 50 years in Zhejiang province, China.Frontiers in public health · 2025Article
- Article
- Cost-effectiveness of the recombinant zoster vaccine (RZV) against herpes zoster: An updated critical review.Human vaccines & immunotherapeutics · 2023Review
- How large could the public health impact of introducing recombinant zoster vaccination for people aged ≥50 years in five Latin American countries be?Human vaccines & immunotherapeutics · 2023Article
- Infectious keratitis: A review.Clinical & experimental ophthalmology · 2022Review
- Cost-Effectiveness Analysis of Herpes Zoster Vaccination in 50- to 85-Year-Old Immunocompetent Belgian Cohorts: A Comparison between No Vaccination, the Adjuvanted Subunit Vaccine, and Live-Attenuated Vaccine.PharmacoEconomics · 2022Article
- Vaccination for quality of life: herpes-zoster vaccines.Aging clinical and experimental research · 2021Review
- Effectiveness and cost-effectiveness of vaccination against herpes zoster in Canada: a modelling study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2019Article
- Disease burden of varicella versus other vaccine-preventable diseases before introduction of vaccination into the national immunisation programme in the Netherlands.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2019Article
- Varicella zoster virus vaccines: an update.ImmunoTargets and therapy · 2019Article
- Avoiding rash decisions about zoster vaccination: insights from cost-effectiveness evidence.BMC medicine · 2018Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe newly registered adjuvanted herpes zoster subunit vaccine (HZ/su) has a higher efficacy than the available live-attenuated vaccine (ZVL). National decision-makers soon need to decide whether to introduce HZ/su or to prefer HZ/su above ZVL.
methodsUsing a Markov model with a decision tree, we conducted a cost-effectiveness analysis of vaccination with HZ/su (two doses within 2 months) or zoster vaccine live (ZVL) (single dose, or single dose with a booster after 10 years) for cohorts of 50-, 60-, 70- or 80-year-olds in the Netherlands. The model was parameterized using vaccine efficacy data from randomized clinical trials and up-to-date incidence, costs and health-related quality of life data from national datasets. We used a time horizon of 15 years, and the analysis was conducted from the societal perspective.
resultsAt a coverage of 50%, vaccination with two doses of HZ/su was estimated to prevent 4335 to 10,896 HZ cases, depending on the cohort age. In comparison, this reduction was estimated at 400-4877 for ZVL and 427-6466 for ZVL with a booster. The maximum vaccine cost per series of HZ/su to remain cost-effective to a willingness-to-pay threshold of €20,000 per quality-adjusted life year (QALY) gained ranged from €109.09 for 70-year-olds to €63.68 for 50-year-olds. The cost-effectiveness of ZVL changed considerably by age, with corresponding maximum vaccine cost per dose ranging from €51.37 for 60-year-olds to €0.73 for 80-year-olds. Adding a ZVL booster after 10 years would require a substantial reduction of the maximum cost per dose to remain cost-effective as compared to ZVL single dose. Sensitivity analyses on the vaccine cost demonstrated that there were scenarios in which vaccination with either HZ/su (two doses), ZVL single dose or ZVL + booster could be the most cost-effective strategy.
conclusionsA strategy with two doses of HZ/su was superior in reducing the burden of HZ as compared to a single dose or single dose + booster of ZVL. Both vaccines could potentially be cost-effective to a conventional Dutch willingness-to-pay threshold for preventive interventions. However, whether HZ/su or ZVL would be the most cost-effective alternative depends largely on the vaccine cost.
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