Open Access Highly Accessed Research article

Public health and economic impact of vaccination with 7-valent pneumococcal vaccine (PCV7) in the context of the annual influenza epidemic and a severe influenza pandemic

Jaime L Rubin1*, Lisa J McGarry1, Keith P Klugman2, David R Strutton3, Kristen E Gilmore1 and Milton C Weinstein4

Author Affiliations

1 i3 Innovus, 10 Cabot Road, Suite 304, Medford, MA 02155, USA

2 Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, N.E - Room 720, Atlanta, GA 30322, USA

3 Pfizer, 500 Arcola Road, Collegeville, PA, 19426, USA

4 Harvard School of Public Health, Harvard University, 718 Huntington Avenue, Boston, MA 02115, USA

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BMC Infectious Diseases 2010, 10:14  doi:10.1186/1471-2334-10-14

Published: 21 January 2010



Influenza pandemic outbreaks occurred in the US in 1918, 1957, and 1968. Historical evidence suggests that the majority of influenza-related deaths during the 1918 US pandemic were attributable to bacterial pneumococcal infections. The 2009 novel influenza A (H1N1) outbreak highlights the importance of interventions that may mitigate the impact of a pandemic.


A decision-analytic model was constructed to evaluate the impact of 7-valent pneumococcal conjugate vaccine (PCV7) on pneumococcal disease incidence and mortality during a typical influenza season (13/100) and a severe influenza pandemic (30/100). Outcomes were compared for current PCV7 vaccination practices vs. no vaccination. The model was estimated using published sources and includes indirect (herd) protection of non-vaccinated persons.


The model predicts that PCV7 vaccination in the US is cost saving for a normal influenza season, reducing pneumococcal-related costs by $1.6 billion. In a severe influenza pandemic, vaccination would save $7.3 billion in costs and prevent 512,000 cases of IPD, 719,000 cases of pneumonia, 62,000 IPD deaths, and 47,000 pneumonia deaths; 84% of deaths are prevented due to indirect (herd) protection in the unvaccinated.


PCV7 vaccination is highly effective and cost saving in both normal and severe pandemic influenza seasons. Current infant vaccination practices may prevent >1 million pneumococcal-related deaths in a severe influenza pandemic, primarily due to herd protection.