Cohort models are often used to assess disease progression over different health states, for measuring total burden over time. That logic becomes complicated when the population composition is highly dynamic in function of age and sex, with changes in health condition, in decreases of immune responses, being relocated over different healthcare settings with different infection transmission risks. Our objective is to identify an alternative to cohort modelling, which also estimates adequately the infection burden, using a transparent evaluation method, that supports decision makers in their choices of applying vaccination of older adults.

Lagging policies for immunization in ageing adults, low vaccine uptakes, and the lack of supportive evidence at the national level could diminish the impacts on health and economics of such programs. This study aims to (i) develop a country score tool designed to assess readiness and facilitate evidence generation with regards to ageing adult immunization programs in Europe, and (ii) examine the comprehensiveness, relevance, acceptability, and feasibility of the tool.

Ageing adults, especially with comorbidities are at risk of Herpes zoster (HZ) and its chronically painful complication, postherpetic neuralgia (PHN). The disease can be prevented by the Recombinant Zoster Vaccine (RZV), but a large-scale RZV program is not advisable in the Netherlands mainly due to its unfavorable cost-effectiveness. This work aims to estimate the incremental cost-effectiveness ratio (ICER) of high-risk and overall-cohort vaccination strategies compared with non-vaccination in 70-year-old Dutch people, and to prioritize future research addressing the uncertainty of the decision model.