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The zoster vaccine is licensed for use in older adults (age, ≥50), but most guidelines endorse its use only starting at age 60, when the incidence of herpes zoster (HZ) begins to climb. To address this discrepancy, researchers assembled a cost-effectiveness analysis of vaccine use among healthy immunocompetent 50- to 59-year-olds. Variables included age-specific rates of HZ, rates and expenses of disease complications, side effects and expense of vaccination, and expected duration of vaccine-related immunity (efficacy declines by an estimated 50% after 5–6 years; NEJM JW Gen Med Apr 1 2015 and Clin Infect Dis 2015; 60:900).
The final model predicted that for every 1000 patients vaccinated at age 50, 25 cases of HZ and 1 case of postherpetic …