OBJECTIVES: Herpes zoster (HZ) is caused by reactivation of latent varicella zoster virus. Age-related immunity decline is the main risk factor for the disease. HZ can lead to debilitating chronic pain (postherpetic neuralgia, PHN) and other complications, impacting work productivity. We assessed the public health and budget impact of vaccination with recombinant zoster vaccine (RZV) to Austrian healthcare payers and to employers, respectively.

METHODS: The health, work and productivity impact of vaccinating 1,000 employees aged 50-64 years versus no RZV vaccination was assessed over 10 years using a multi-cohort Markov model. Health outcomes were HZ, PHN and non-PHN complications. Corresponding healthcare resource use and direct medical costs were evaluated. From the company perspective, productivity losses due to absenteeism and presenteeism (i.e., reduced working capacity following HZ), with their related indirect costs, were compared in scenarios with versus without vaccination. The model considered an average of 3.95 days of absenteeism and 10.55 days of presenteeism per HZ episode, at a productivity cost of €299.84 per day.

RESULTS: The model predicted that vaccination would prevent 72 HZ, 10 PHN and 9 non-PHN complication cases, thereby averting 288 general practitioner visits and saving the healthcare system €30,584 in direct medical costs. Vaccination would prevent 1,044 days of productivity loss, averting €313,161 to the company in indirect costs (€85,309 due to absenteeism and €227,852 due to presenteeism).

CONCLUSIONS: The introduction of RZV programs by companies in Austria could enable employees to stay healthy and productive for longer. While this analysis focused on benefits over 10 years, studies predict lifetime RZV vaccine efficacy. More research is needed on local absenteeism and presenteeism following HZ, as this can vary across countries. With a rapidly growing population of older adult employees, vaccines can play an increasingly important role in maintaining good health, quality of life and productivity.