Table 3.
Impact, effectiveness and cost-effectiveness of vaccination of Dutch immunocompetent older adults against HZ at a coverage of 50% over a period of 15 years. Vaccination strategies include the herpes zoster subunit vaccine (two doses) or zoster vaccine live (single dose, or single dose + booster after 10 years). Future costs and quality-adjusted life years (QALYs) include an annual discount rate of 4% and 1.5%, respectively
| Vaccination strategy | Total HZ cases | HZ cases averted | PHN cases averted | QALYs gained | Total costs saved (€, millions) | NNV to prevent a HZ case | Threshold vaccine cost to equal €20,000 per QALY (€)a | Threshold vaccine cost to equal €50,000 per QALY (€)a |
|---|---|---|---|---|---|---|---|---|
| 50 years | ||||||||
| No vaccination | 22,613 | |||||||
| ZVL | 18,618 | 3995 | 118 | 159.3 | 2.060 | 31.7 | 29.59 | 67.29 |
| ZVL + booster | 16,392 | 6220 | 281 | 268.1 | 2.777 | 20.4 | 27.09 | 65.51 |
| HZ/su | 14,141 | 8472 | 324 | 351.6 | 4.026 | 15.0 | 63.68 | 146.91 |
| 60 years | ||||||||
| No vaccination | 27,093 | |||||||
| ZVL | 22,215 | 4877 | 358 | 266.9 | 1.698 | 22.8 | 51.37 | 123.23 |
| ZVL + booster | 20,627 | 6466 | 474 | 345.5 | 2.012 | 17.2 | 37.79 | 95.37 |
| HZ/su | 16,833 | 10,260 | 753 | 548.9 | 3.270 | 10.9 | 104.30 | 252.09 |
| 70 years | ||||||||
| No vaccination | 31,481 | |||||||
| ZVL | 28,368 | 3113 | 228 | 176.9 | 0.724 | 34.9 | 27.48 | 76.38 |
| ZVL + booster | 27,645 | 3836 | 281 | 215.4 | 0.865 | 28.3 | 19.43 | 58.42 |
| HZ/su | 20,585 | 10,896 | 799 | 599.9 | 2.400 | 10.0 | 109.09 | 274.91 |
| 80 years | ||||||||
| No vaccination | 11,449 | |||||||
| ZVL | 11,050 | 400 | 29 | 24.7 | 0.092 | 117.0 | 0.73 | 16.56 |
| ZVL + booster | 11,022 | 427 | 31 | 26.4 | 0.095 | 109.5 | − 1.45 | 11.69 |
| HZ/su | 7114 | 4335 | 318 | 256.6 | 0.930 | 10.8 | 106.03 | 270.59 |
HZ herpes zoster, HZ/su herpes zoster subunit vaccine, NNV number needed to vaccinate, PHN post-herpetic neuralgia, QALY quality-adjusted life-year, ZVL zoster vaccine live (live-attenuated vaccine)
aCost per series (two doses) of HZ/su or cost per dose of ZVL. Administration costs of €11.36 per dose and travel costs of €0.43 per dose are not included