The epidemiology and cost-effectiveness of vaccination strategies against infectious diseases: a focus on Varicella zoster, pandemic influenza A/H1N1 2009, and Streptococcus pneumoniae

Albert Jan van Hoek

    Research output: ThesisThesis fully internal (DIV)

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    Varicella zoster virus causes chickenpox en shingles. A vaccine is available against both diseases. In chapter 2 and 3 I show that vaccination of elderly against shingles is cost-effective in England, and marginal cost-effective in the Netherlands. In chapter 4 and 5 the question if children should be vaccinated against chickenpox is investigated. It is suggested that when there is no chickenpox around the chance to develop shingles increases. Therefore vaccination against chickenpox is only cost-effective on the very long term; when everybody is less likely to develop shingles due to childhood vaccination.
    During the 2009 H1N1 pandemic the question was raised how to use the pandemic vaccine: only vaccinating children, elderly, risk groups or a combination. In chapter 6 the impact of H1N1 on the quality of life is described and in chapter 7 a ‘real time’ cost effectiveness analysis is presented. Our analysis shows that focussing on risk groups was the best use of the vaccine in England at the time the vaccine was available.
    Streptococcus pneumoniae is a bacteria with 90+ serotypes. In chapter 8 and 9 the effect and impact of serotype replacement is analysed, as the conjugate vaccine (PCV) only protects against 7, 10 or 13 serotypes. In chapter 10 and 11 it is shown that vaccinating risk groups with PCV is not cost-effective and in chapter 12 and 13 I use serotype specific disease outcomes to conclude that vaccination of children with PCV is still cost-effective.
    Original languageEnglish
    • Postma, Maarten, Supervisor
    • Edmunds, W.J., Supervisor, External person
    • Miller, E., Supervisor, External person
    Award date25-Feb-2013
    Print ISBNs9789036760324
    Electronic ISBNs9789036760843
    Publication statusPublished - 2013

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