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Table 2 An overview of the model of Kimman et al. [9] for herpes zoster, pneumococcal disease, pertussis and hepatitis A

From: Assessment of vaccine candidates for persons aged 50 and older: a review

  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
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