OBJECTIVES: The risk of herpes zoster (HZ) and post-herpetic neuralgia (PHN) increases with age and as a result of an immunosuppressive disease and therapy. Here, we model the impact of a recombinant zoster vaccine (RZV) on public health measures in immunocompromised (IC) individuals aged 18 to 49 years in Germany.

METHODS: The Zoster economic Analysis IC model – a static Markov model- was fitted with inputs from an extensive literature search. To assess immunocompromised individuals, we evaluated scenarios involving individuals with autologous hematopoietic stem cell transplantation (HSCT), patients with the human immunodeficiency virus (HIV), and patients who had a renal transplantation (RT). Parameters such as HZ incidence, duration of IC condition or estimated vaccine efficacy differed among the populations. For each population, in a base case scenario, a hypothetical non-vaccinated cohort was compared to a fully vaccinated cohort and the number of HZ and PHN cases were computed over a 30-year time horizon. The number needed to vaccinate (NNV) to prevent one HZ infection was estimated.

RESULTS: Among a 2,500 HIV population, RZV would avert 572 (63%) HZ and 56 (57%) PHN cases. For a 1,000 HSCT population, RZV would prevent a total of 83 (34%) HZ cases and 20 (56%) PHN cases. For 1,000 RT patients, a reduction of 121 (31%) HZ and 11 (26%) PHN cases was estimated. The NNV to prevent one HZ case was 4 for HIV, 12 for HSCT and 8 for RT.

CONCLUSIONS: Vaccination with RZV would lead to a significant reduction in the HZ-related disease burden in individuals with immunosuppression aged 18 to 49 years in Germany. To complement this initial evaluation, future studies may include more conditions and therapies, more recent epidemiological data and account for costs averted.