The epidemiology of herpes zoster and potential cost-effectiveness of vaccination in England and Wales

The epidemiology of herpes tester and post-herpetic neuralgia (PHN) was qua ntified from a variety of data sources acid the potential cost-effectivenes s of vaccination assessed. The annual incidence and severity of tester incr eases sharply with age, as measured by physician consultation and hospitali sation rates, average length of stay, average proportion of cases developin g PHN and the age-specific case-fatality ratio. Combining these data with i nformation on health related quality of life results in an estimated loss o f 20000 quality adjusted life years (QALYs) annually in England and Wales f rom herpes tester (17400 due to PHN). The current cost of treating herpes z oster associated disease is estimated to be pound 47.6m annually. Since bot h the health and economic burden are high, vaccination of the elderly is ex pected to be cost-effective under most scenarios. the attractiveness of imm unisation increasing with age due to the increased burden of disease in the very elderly. (C) 2001 Elsevier Science Ltd. All rights reserved.