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 |