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

PhD ceremony: Mr. A.J. van Hoek, 14.30 uur, Academiegebouw, Broerstraat 5, Groningen

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

Promotor(s): prof. M.J. Postma, prof. W.J. Edmunds

Faculty: Mathematics and Natural Sciences

Varicella zoster virus causes chickenpox en shingles. A vaccine is available against both diseases. Albert Jan van Hoek shows amongst other results that vaccination of elderly against shingles is cost-effective in England, and marginal cost-effective in the Netherlands.

Van Hoek also investigated the question if children should be vaccinated against chickenpox. He suggests 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. The impact of H1N1 on the quality of life is described by Van Hoek and he also has presented a ‘real time’ cost effectiveness analysis. His 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. Van Hoek has analysed the effect and impact of serotype replacement, as the conjugate vaccine (PCV) only protects against 7, 10 or 13 serotypes. It is shown by him that vaccinating risk groups with PCV is not cost-effective and he uses serotype specific disease outcomes to conclude that vaccination of children with PCV is still cost-effective.