Josephine van Dongen

3 Updated cost-effectiveness and risk-benefit analysis 67 Disease and cost burden AGE epi- sodes (× 1000) Hospi- taliza- tions a (× 1000) Fatal cases Vaccine- induced IS QALYs lost b Life years lost b Net societal costs b (mio €) Percent reduc- tion 3.4% (2.9– 4.0%) 14.7% (13.9– 15.3%) 89.8% (86.7– 92.2%) NA 42.7% (23.0– 57.7%) 85.6% (72.3– 97.2%) 9.4% (8.0– 11.0%) NA Percent reduc- tion 53.2% (48.1– 58.4%) 74.4% (71.9- 76.5%) 93.9% (92.7– 94.8%) NA 72.9% (63.0– 81.1%) 92.1% (82.5– 99.3%) NA NA Universal vaccination vs targeted vaccination d Absolute change 622 (451– 810) 32 (28–36) 4 (1–12) 53.79 769 (561– 1003) 90 (9–239) 115 (94–131) 149,282 (101,101 220,113) Percent reduc- tion 51.5% (46.5– 56.7%) 70% (67.4– 72.3%) 39.5% (26.9– 53.4%) NA 52.8% (47.6– 58.8%) 48.2% (25.4– 88.6%) NA NA a Including nosocomial infections b Using a 3% discount rate for effects (QALYs/life years) and costs c Negative costs are savings d Comparing universal vaccination to targeted vaccination in order to obtain the incremental results of extending targeted vaccination to universal vaccination Fig. 3 Cost-effectiveness plane for targeted vaccination (depicted in red) and universal vaccination (depicted in green) using a societal perspective and a 3% discount rate