{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:48:27Z","timestamp":1785408507990,"version":"3.56.0"},"reference-count":58,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72122001"],"award-info":[{"award-number":["72122001"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"award":["72122001"],"award-info":[{"award-number":["72122001"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: The recombinant zoster vaccine (RZV) has been shown to reduce the risk of dementia and delay cognitive decline. However, economic evaluations in populations with mild cognitive impairment (MCI), particularly those incorporating cognitive outcomes, remain unavailable. This study evaluated the cost-effectiveness of RZV vaccination at age 50 among Chinese adults with MCI. Methods: A decision tree\u2013Markov model was developed from a societal perspective to assess the lifetime cost-effectiveness of RZV (Shingrix, GSK) in a cohort of 1 million immunocompetent Chinese adults with MCI receiving vaccination at the age of 50. The primary outcome was the incremental cost-effectiveness ratio (ICER), while secondary outcomes included cases averted and the number needed to vaccinate (NNV) to prevent one case of herpes zoster (HZ), postherpetic neuralgia (PHN), and dementia. A willingness-to-pay (WTP) threshold equivalent to the 2024 Chinese gross domestic product (GDP) per capita (13,121 USD) was applied. Sensitivity analyses were conducted to test the robustness of the results. Results: Over a lifetime horizon, RZV vaccination was estimated to avert 54.64% of HZ cases, 97.58% of PHN cases, and 12.28% of dementia cases compared with no vaccination, resulting in an additional 2.23 million quality-adjusted life years (QALYs) gained. The ICER was 4216.99 USD\/QALY, remaining well below the WTP threshold. The corresponding NNVs were 6.25 for HZ, 24.03 for PHN, and 280.82 for dementia progression. Conclusions: RZV vaccination is cost-effective for Chinese adults aged 50 years with MCI, providing substantial health gains through reductions in both HZ burden and dementia progression.<\/jats:p>","DOI":"10.3390\/vaccines14050406","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:33:17Z","timestamp":1777627997000},"page":"406","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-Effectiveness Analysis of Recombinant Zoster Vaccine at Age 50 for Chinese Adults with Mild Cognitive Impairment: A Modelling Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Yifei","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Yao","sequence":"additional","affiliation":[{"name":"School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China"},{"name":"Center for Healthy Aging Transdisciplinary Sciences, China Center for Health Development Studies, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1938-9365","authenticated-orcid":false,"given":"Jue","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China"},{"name":"Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China"},{"name":"Institute for Global Health and Development, Peking University, No. 5 Yiheyuan Road, Haidian District, Beijing 100871, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"k5095","DOI":"10.1136\/bmj.k5095","article-title":"Herpes Zoster Infection","volume":"364","author":"Le","year":"2019","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1080\/14787210.2020.1792290","article-title":"A Systematic Literature Review to Assess the Burden of Herpes Zoster Disease in China","volume":"19","author":"Yin","year":"2021","journal-title":"Expert Rev. 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