ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2019
Effectiveness and cost-effectiveness of vaccination against herpes zoster in Canada: a modelling study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 23 citations in OpenAlex.
- Article
- Cost Effectiveness of the Adjuvanted Recombinant Zoster Vaccine in Older Adults in Portugal.PharmacoEconomics - open · 2026Article
- Rising Burden of Herpes Zoster among General Adults and Increased-Risk Groups in Eastern China, 2015-2021: A Population-Based Cohort Study.Infectious diseases and therapy · 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 and public health impact of recombinant zoster vaccine versus no herpes zoster vaccination in selected populations of immunocompromised adults in Canada.BMC health services research · 2025Article
- Cost-effectiveness analysis of herpes zoster vaccination for adults aged 50 years in Zhejiang province, China.Frontiers in public health · 2025Article
- Attitudes, barriers, and facilitators to adherent completion of the recombinant zoster vaccine regimen in Canada: Qualitative interviews with healthcare providers and patients.Human vaccines & immunotherapeutics · 2024Article
- Article
- Updated Public Health Impact and Cost Effectiveness of Recombinant Zoster Vaccine in Canadian Adults Aged 50 Years and Older.PharmacoEconomics - open · 2024Article
- Cost-effectiveness of the recombinant zoster vaccine (RZV) against herpes zoster: An updated critical review.Human vaccines & immunotherapeutics · 2023Review
- 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
- Adult preventive vaccines with other synergistic lifestyle options: is it time to add these ancillary benefits to the overall AS management checklist?World journal of urology · 2022Review
- Herpes zoster in older adults in Ontario, 2002-2016: Investigating incidence and exploring equity.PloS one · 2021Article
- Cost-effectiveness of varicella and herpes zoster vaccination in Sweden: An economic evaluation using a dynamic transmission model.PloS one · 2021Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTwo vaccines against herpes zoster are currently authorized for use in Canada: the recombinant subunit zoster vaccine and live attenuated zoster vaccine. We compared the effectiveness and cost-effectiveness of these 2 vaccines.
methodsWe used a decision analytic static cohort model parametrized with Canadian epidemiologic and economic data. We performed the economic analysis from the health care system perspective, using a lifetime horizon and a 3% discount rate for costs and benefits. The primary outcome was the incremental cost per quality-adjusted life-year (QALY) gained, relative to no vaccination. We ran 30 000 simulations varying all model parameters, including vaccine costs, efficacy and waning.
resultsThe number needed to vaccinate (NNV) was higher for the live attenuated zoster vaccine than for the recombinant subunit zoster vaccine for all herpes zoster-related events at all ages. For example, in persons exactly 65 years old, for herpes zoster, median NNV was 21 (90% uncertainty interval [UI] 13-31) versus 8 (90% UI 6-18), and for postherpetic neuralgia, NNV was 64 (90% UI 33-93) versus 31 (90% UI 23-73). For the recombinant vaccine, the median cost-effectiveness ratios varied between cost-saving and $25 881 per QALY gained for adults aged 50 years or older. For the live vaccine, the cost-effectiveness ratios varied between cost-saving and $130 587 per QALY gained and were less than $45 000 per QALY gained only for those 65 to 75 years old. Given its higher efficacy, we estimated that the cost for the complete series of the recombinant vaccine could be $150 to $200 more than the cost of the live vaccine and still be considered cost-effective.
interpretationOur model predicted that the recombinant subunit zoster vaccine is likely cost-effective in Canada for adults 60 years or older, and is likely more cost-effective than live attenuated zoster vaccine. These results have informed updated national and provincial recommendations on herpes zoster vaccination.
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