ArticleBMC health services research2025
Cost-effectiveness and public health impact of recombinant zoster vaccine versus no herpes zoster vaccination in selected populations of immunocompromised adults in Canada.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Cost-effectiveness of herpes zoster vaccination in patients with rheumatoid arthritis.Rheumatology (Oxford, England) · 2026Article
- Cost-utility and budget impact analysis of herpes zoster vaccines in Thai patients with end-stage renal disease.Journal of pharmaceutical policy and practice · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundThe risk of herpes zoster (HZ) increases with age and in immunocompromised (IC) patients. Recombinant zoster vaccine (RZV) is currently recommended in Canada for people aged ≥ 50 years. The objectives of the current study were to evaluate the cost-effectiveness and public health impact of RZV versus no HZ vaccination in select Canadian IC adult populations.
methodsThe ZOster ecoNomic Analysis ImmunoCompromised (ZONA IC) model followed a base-case cohort of 1600 patients with hematopoietic stem-cell transplant (HSCT) from a starting age of 55 years, who maintained IC status for 5 years, from a societal perspective. Scenario analyses were conducted for patients with breast cancer, renal transplant, human immunodeficiency virus (HIV), and Hodgkin lymphoma. These probabilistic analyses used a life-long time horizon and discount rates of 1.5% for costs and quality-adjusted life-years (QALYs). First-dose coverage was assumed to be 60% and second-dose completion 100%. Deterministic one-way sensitivity analysis for the base case was performed. Costs are reported in 2022 Canadian dollars, with an assumed cost-effectiveness threshold of $50,000 per QALY gained.
resultsIn the base-case analysis (HSCT), it was estimated that RZV would prevent medians of 116 HZ and 27 postherpetic neuralgia (PHN) cases, respectively versus no HZ vaccination. Estimated median numbers needed to vaccinate were 8 and 35 to avoid one HZ and one PHN case, respectively. The median incremental cost-effectiveness ratio (ICER) was $22,648 per QALY gained and was most sensitive to assumptions of HZ incidence, direct medical costs for unvaccinated HZ without PHN, and RZV efficacy against PHN. In other IC populations, estimated median ICERs were $24,328 (breast cancer), $27,237 (renal transplant), $67,207 (HIV), and $81,470 (Hodgkin lymphoma).
conclusionsRZV in Canada improves public health outcomes and is likely cost-effective for several IC conditions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.