Table 2.
Herpes zoster incidence, burden of disease, and vaccine availability in countries with developed economies.
| Country | ZVL license year | RZV license year | Year HZ vaccine in schedule | Eligible age | Vaccine(s) currently in use | Estimated annual incidence per 1000 person years (age range) | Estimated annual cost of HZ a (Direct b /Indirect c ), in millions |
|---|---|---|---|---|---|---|---|
| North America | |||||||
| Canada | 2011 | 2017 | 2011 | 50+ | RZV | 2011: 9.7 [60–64], 12.7 [65–69], 14.6 [70–74], 15.2 [75–79] 42 | $65.43 43 /– |
| United States | 2006 | 2017 | 2006 | 50+ | RZV | 2011: 8.46 [50–59], 10.46 [60+] (2011) 44 | $2645.11 5 /– |
| Europe | |||||||
| Austria | 2006 | 2018 | 2019 | 50+, 18+ (ICs) | RZV | ||
| Czech Republic | 2006 | 2018 | 2019 | 50+, 18+ (ICs) | ZVL/RZV | 2008: 1.55 [70+] 45 | - |
| France | 2006 | 2018 | 2015 | 65–74 | ZVL | 2005–8: 4.16 [45–54], 5.77 [55–64], 8.68 [65–74], 9.85 [75–84] 46 | $237.03 47 |
| Germany | 2006 | 2018 | 2018 | 60+, 50+ (MCs) | RZV | 2007–8: 6.21 [50–54], 7.59 [55–59], 8.94 [60–64], 10.70 [65–69], 11.34 [70–74], 12.15 [75–79] 48 | $135.46/234.33 49 |
| Greece | 2006 | 2018 | 2011 | 60+ | ZVL | 2007–9: 1.6 [all ages] 50 | |
| Ireland | 2006 | 2018 | - | 50+ (MCs) | ZVL/RZV | $2.65 51 /– | |
| Italy | 2006 | 2018 | 2017 | 65+, 50+ (MCs) | ZVL/RZV | 2013–15: 3.95 [50–54], 5.55 [55–59], 6.45 [60–64], 6.07 [65–69], 9.06 [70–74], 8.19 [75–79] 52 | $39.73/18.31 53 |
| Spain | 2006 | 2018 | 2021 | 50+, 18+ (Ics) | ZVL/RZV | 2006–7: 6.7 [50–59], 5.2 [60–69], 11.1 [70+] 54 | $4.48/4.97 55 |
| The Netherlands | 2006 | 2018 | 2019 (Conditional) | 60+ | ZVL/RZV | 2011: 3.6 [all age groups] 56 | $3.08/$1.72 57 |
| Norway | 2006 | 2018 | 50+ | ZVL | 2008–14: 2.77 [50–59], 4.38 [60–69], 6.63 [70–79], 7.59 [80+] 58 | 9.6 59 /– | |
| Sweden | 2006 | 2018 | 50+ | ZVL/RZV | 2011: 3.15 [all ages], 5.77 [50+] 60 | –/$28.0 60 | |
| Switzerland | 2007 | - | 2017 | 65–79, 50+ if anticipate immunosuppression | ZVL | 2010: 3.06 [50–54], 3.06 [55–59], 4.14 [60–64], 4.14 [65–69], 5.99 [70–74]. 5.99 [75–79] 61 | $4.63/15.7161,62 |
| United Kingdom | 2006 | - | 2013 | 70–79 | ZVL | 2000–6: 4.90 [60–69], 5.96 [65–69], 6.34 [70–74], 7.09 [75–79] 63 | $29.25 43 /– |
| Oceania | |||||||
| Australia | 2006 | 2018 | 2015 | 60+, 50–59 (IC) | ZVL/RZV | 2007–12: 6.3 [50–59], 13.66 [60–69], 15.31 [70–79] 64 | $31.75 65 |
| New Zealand | 2012 | 2020 | 2018 | 65. 50–64 (MCs) | ZVL | 2005–15: 4.86 (all ages) 66 | |
| Asia | |||||||
| Japan | 2016 (VLL) | 2018 | 2016 | 50+ | VVL/RZV | 1997–2006: 5.23 [50–59], 6.95 [60–69], 7.84 [70–79] 67 | $185.33/241.52 68 |
| Singapore | 2008 | 2021 | 2016 | 60+ | ZVL/RZV | –/$40.9 69 | |
| South Korea | 2009 | 2017 (Sky-Zoster) | 2012 | 60+, 50+ (MCs) | ZVL/Sky-Zoster | 2011: 17.4 (50–59), 22.4 (60–69), 21.8 (70–79 70 | $189.67/30.84 71 |
COPD, chronic obstructive pulmonary disease; HZ, herpes zoster; IC, with immunocompromised state; MCs, with medical comorbidities; RZV, recombinant zoster vaccine, or Shingrix; VZV, varicella-zoster virus; VVL, varicella vaccine live; ZVL, zoster vaccine live, or Zostavax.
a
Cost of HZ and its complications (e.g. PHN).
b
Direct costs include cost to healthcare system and/or direct medical costs.
c
Indirect costs include societal costs incurred due to loss of productivity (e.g. time away from work).