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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

Yes

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