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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

From: Cost-effectiveness of vaccination of immunocompetent older adults against herpes zoster in the Netherlands: a comparison between the adjuvanted subunit and live-attenuated vaccines

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
  1. 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)
  2. 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