To the Editor The research letter by Le and Rothberg1 provides an economic evaluation of the adjuvanted recombinant zoster vaccine (RZV) in adults aged 50 to 59 years, as well as additional vaccination with RZV following initial vaccination with the zoster vaccine live (ZVL). In 2017, the Advisory Committee on Immunization Practices (ACIP) recommended the RZV vaccination: (1) for immunocompetent adults 50 years and older, (2) for immunocompetent adults previously vaccinated with ZVL, and (3) over ZVL.2 Based on their analysis, Le and Rothberg1 concluded that neither of the first 2 ACIP recommendations is cost-effective. However, their analysis focuses only on limited aspects of the ACIP recommendations (eg, vaccination at exact ages, such as 50 years), rather than vaccination of a population 50 years and older, which would better reflect the ACIP recommendation. They also focused on immediate additional vaccination with RZV, whereas the ACIP recommendation2 leaves open the time interval for additional vaccination with RZV (with the exception that it should not be given <2 months after receipt of ZVL).