Table 2.

An overview of the model of Kimman et al. [9] for herpes zoster, pneumococcal disease, pertussis and hepatitis A

	Pathogen		Disease				Vaccine						Cost-effectiveness
	Bacteria or virus	Clinical picture	Age-related risk	Morbidity		Mortality	Efficacy	Side effects	No. of doses	Period of protection	Administration with other vaccines	Costs + reimbursement (in the Netherlands)
				GP consultation (incidence)	Hospital admission (incidence)
Herpes zoster	Herpes zoster virus (reactivation of varicella zoster virus)	Painful itchy rash, PHN	Risk increases with age50% >85 years	717/ 100,000 (≥50 years)	9.4/100,000 (≥50 years)	Low	51.3% -66.5%	Mostly local symptoms and headaches	1	6 years?	Influenza vaccine. Zostavax and pneumococcal vaccine should be given 4 weeks apart	€43.91/137.33, no reimbursement	Marginal
Pneumococcal disease	Staphylococcus pneumoniae	Pneumonia, Meningitis, Bacteraemia	Incidence rises with age	-	590/100,000 (>50 year)	20%	PPV23: strong indication for preventing IPD Prevenar13: currently investigated	Mostly local symptoms and headaches	2?	3-5 years?	Influenza vaccine, Zostavax and pneumococcal vaccine should be given 4 weeks apart	Prevenar13: €67.72, no reimbursement Pneumo23: €14.97-, reimbursementunder certain circumstances	Yes
Pertussis	Bordetella pertussis	Influenza-like symptoms and chronic paroxysmal cough	Pertussis becomes more prevalent among those ≥50 years	10,388 >45 years 2002-2005	28 >45 years 2002-2005	Low	Secondary vaccine failure is present in older persons	Mild symptoms	Possible multiple	4-12 years in children	Havrix may be given simultaneously	€21.18, no reimbursement	Unknown
Hepatitis A	Hepatitis A virus	Jaundice, fever, nausea, vomiting, liver failure	Aging increases susceptibility	Morbidity increases with age		1.8%	Epaxal: 100% after 2 doses	Mostly local symptoms, headaches and fatigue	2	12-25 years, possibly lifelong	Boostrix may be given simultaneously	Epaxal and Havrix: €21.63-32.45, no reimbursement	Highly unlikely