title: Burden of four vaccine preventable diseases in older adults.
abstract: BACKGROUND
  Implementation of additional targeted vaccinations to prevent infectious diseases in the older adults is under discussion in different countries. When considering the added value of such preventive measures, insight into the current disease burden will assist in prioritization. The aim of this study was derive the first estimates of the disease burden in adults aged 50 years or over in the Netherlands for influenza, pertussis, pneumococcal disease and herpes zoster.
  
  
  METHODS
  The average annual disease burden for these four diseases in the Netherlands was calculated for the period 2010-2013 using the disability-adjusted life years (DALY) measure. Disease models and parameters were obtained from previous research. Where possible we adapted these models specifically for older adults and applied age-specific parameters derived from literature. The disease burden based on these adapted models and parameters was compared with the disease burden based on the general population models.
  
  
  RESULTS
  The estimated average annual disease burden was from high to low: pneumococcal disease (37,223 DALYs/year), influenza (7941 DALYs/year), herpes zoster (942 DALYs/year), and pertussis (812 DALYs/year). The adaptation of models and parameters specifically for the elderly resulted in a higher disease burden compared to the use of general population models.
  
  
  CONCLUSIONS
  Among older adults, the disease burden in the period 2010-2013 was highest for pneumococcal disease, mostly because of high mortality, followed by influenza. Disease burden of herpes zoster and pertussis was relatively low and consisted mostly of years lived with disability. Better information on the course of infectious diseases and long-term consequences would enable more accurate estimation of disease burden in older adults.
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: maartjekristensen@gmail.com.
authors.forename: Maartje
authors.initials: M
authors.lastname: Kristensen
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: alies.van.lier@rivm.nl.
authors.forename: Alies
authors.initials: A
authors.lastname: van Lier
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Epidemiology, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: renske.eilers@rivm.nl.
authors.forename: Renske
authors.initials: R
authors.lastname: Eilers
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: scott.mcdonald@rivm.nl.
authors.forename: Scott A
authors.initials: SA
authors.lastname: McDonald
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: wopstel2@umcutrecht.nl.
authors.forename: Wim
authors.initials: W
authors.lastname: Opstelten
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: nicoline.van.der.maas@rivm.nl.
authors.forename: Nicoline
authors.initials: N
authors.lastname: van der Maas
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: wim.van.der.hoek@rivm.nl.
authors.forename: Wim
authors.initials: W
authors.lastname: van der Hoek
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: mirjam.kretzschmar@rivm.nl.
authors.forename: Mirjam E
authors.initials: ME
authors.lastname: Kretzschmar
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands. Electronic address: m.nielen@nivel.nl.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Nielen
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: hester.de.melker@rivm.nl.
authors.forename: Hester E
authors.initials: HE
authors.lastname: de Melker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D006562:Herpes Zoster / Q000453:epidemiology*; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology*; D008875:Middle Aged; D015233:Models, Statistical; D009426:Netherlands / Q000453:epidemiology; D011008:Pneumococcal Infections / Q000453:epidemiology*; D019057:Quality-Adjusted Life Years; D014611:Vaccination; D014917:Whooping Cough / Q000453:epidemiology*
keywords: Disability-adjusted life years (DALY); Disease burden; Herpes zoster; Influenza; Older adults; Pertussis; Pneumococcal disease