Shingles vaccination of older adults cost-effective in Canada

Vaccinating older adults against shingles in Canada is likely cost-effective, according to a study in CMAJ (Canadian Medical Association Journal), and the Shingrix vaccine appears to provide better protection than the Zostavax vaccine.

Herpes zoster, or shingles, affects about 1 in every 3 adults, causing a painful rash that can result in long-term pain in 8% to 27% of people.

The study used a model to compare the effectiveness and cost-effectiveness of the recombinant subunit (RZV, Shingrix) and live attenuated zoster (LZV, Zostavax) vaccines in adults aged 50 years and older in Canada. The LZV vaccine has been available in Canada since 2008, and RZV was approved in 2017.

The number of people needed to be vaccinated to prevent one case of shingles was lower for RZV (Shingrix) than for LZV (Zostavax) for all ages. For example, in people aged 60 years, the number needed to vaccinate was 18 for RZV and 78 for LZV.

"Our model predicted that the recombinant subunit zoster vaccine is likely cost-effective in Canada for adults 60 years or older and that it provides greater health benefits than the live attenuated zoster vaccine for all age groups," writes Dr. Marc Brisson, Centre de research du Centre hospitalier de l'Université de Québec and the Université Laval, Québec, Quebec, with coauthors.

The study results are consistent with other economic evaluations in the United States and the Netherlands.