OBJECTIVES: The primary objective of this study was to quantify the economic burden associated with the excess herpes zoster cases occurring in elderly Hispanic patients due to disparities in receipt of Zostavax®.

METHODS: Markov models were utilized to estimate the costs and number of cases of herpes zoster occurring in elderly U.S. Hispanics ages 60 to 84 over a 20 year period. Direct medial costs and indirect costs were included and the study was conducted from a societal perspective. In the status quo scenario 9.1% of Hispanics age 60 to 64 and 19.2% of Hispanics over age 65 were assumed to receive the shingles vaccine in accordance with recent CDC data. In the health equity scenario 25.1% of Hispanics age 60 to 64 and 38.3% of Hispanics over age 65 were assumed to receive the shingles vaccine in accordance with recent CDC data. The incidence of shingles in the absence of vaccination was age dependent and varied from 5.90 to 9.76 cases per 1,000 person years in accordance with epidemiological data. The vaccine effectiveness varied according to the age of the recipient and the number of years the vaccine had been received with a mean effectiveness of approximately 51%. Direct medical costs for treatment of herpes zoster and resulting complications were obtained from the medical literature and updated to 2016 dollars using the medical CPI. Costs to estimate lost productivity were estimated from the literature and updated using the social security wage index.

RESULTS: Shingles vaccine disparities were demonstrated to be associated with over 34,000 cases of preventable shingles cases. The shingles vaccine disparities were demonstrated to lead to over $172,000,00 in potentially avoidable treatment costs.

CONCLUSIONS: Continued failure to achieve health equity in shingles vaccine status is likely to result in a substantial public health and economic burden.