The epidemiological effect and cost-effectiveness of expanded age eligibility for recombinant zoster vaccination in England.

Ku C-C., Rosello A., Walker J., Pouwels KB., Baguelin M., Davies NG., Jit M.

INTRODUCTION: Since September 2023, England's national immunisation programme has offered the recombinant zoster vaccine (RZV) to adults aged 65-79 as a preventative measure against shingles (herpes zoster) and its complications. However, adults aged 80 and over are currently not eligible for the vaccine. We aimed to evaluate the feasibility and cost-effectiveness of providing RZV to adults aged 80 and older in England. METHODS: This cost-utility analysis employs a static cohort model considering herpes zoster (HZ) cases and severe cases leading to post-herpetic neuralgia, HZ-related hospitalisation, and deaths from the perspective of the National Health Service. The long-term impacts of RZV are assessed using the model, accounting for changing population demographics and the previously-offered live zoster vaccine (ZVL). We consider different eligibility scenarios for RZV focusing on the older population (80+ years old) and provide comparisons to the pre-2023 programme. RESULTS: Expanding the current programme to offer a single dose of RZV to people aged 80 and up is likely to be cost-effective relative to the current programme. Offering two doses to this group would be less cost-effective but would offer greater protection against HZ. For preventing health-related quality of life loss, it is most efficient to vaccinate 60-69-year-olds, but for averting hospitalisation costs, it is most efficient to vaccinate 80-89-year-olds. CONCLUSION: Providing one or two doses of RZV for older adults can be cost-effective and would reduce the healthcare burden of shingles.

DOI

10.1016/j.vaccine.2026.128405

Type

Journal article

Publication Date

2026-03-04T00:00:00+00:00

Volume

78

Keywords

Elderly, Health-economic evaluation, Herpes zoster, Policy projection, Recombinant zoster vaccine, Shingles

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