Given that the herpes zoster subunit vaccine (HZ/su) is more efficacious than the available life-attenuated vaccine (ZVL), researchers conducted to study to determine whether to introduce HZ/su or prefer HZ/su vs ZVL. They used a Markov model for cost-effective analysis of vaccination with HZ/su (two doses within 2 months) or ZVL (single dose, or single dose with a booster following 10 years) for cohorts of individuals aged 50, 60, 70, or 80 years in the Netherlands. They estimated two doses of HZ/su vaccination (at a coverage of 50%) to prevent 4,335-10,896 HZ cases. This reduction was projected at 400–4877 for ZVL and 427–6466 for ZVL with a booster. According to findings, two doses of HZ/su was superior in HZ burden reduction vs a single dose or single dose plus booster of ZVL. Overall, both vaccines may be cost-effective to a conventional Dutch willingness-to-pay threshold for preventive interventions. Yet, vaccine cost would largely determine whether which of the two vaccines would be most cost-effective in the end.