Cost effectiveness analysis of heptavalent pneumococcal conjugate vaccine in Germany considering herd immunity effects

Eur J Health Econ. 2009 Feb;10(1):25-38. doi: 10.1007/s10198-008-0098-1. Epub 2008 Apr 1.


Background: In Germany the heptavalent pneumococcal conjugate vaccine (PCV7) has been recommended as a general infant vaccination since 2006. Data from similar programmes in the USA have reported a reduction of pneumococcal diseases in both vaccinated and unvaccinated populations, suggesting herd immunity effects. This study analyses the cost-effectiveness of a general vaccination with PCV7 in Germany based on these findings.

Methods: A Markov model adapts efficacy and herd immunity data to the German population. Further main model inputs are incidence, vaccination uptake, serotype distribution, case fatality rates, and vaccination and health-care costs.

Results: A general vaccination with PCV7 would avoid about 232,000 pneumococcal infections and 1,879 premature deaths per year in Germany. From the health-care payer's perspective, direct cost savings would outweigh vaccination expenditures by a ratio of 1:1.16. The sensitivity analysis shows that these estimates are quite conservative.

Conclusion: Based on the health-economic evaluation, the authors recommend the continuation of the general recommendation of PCV7 according to the 3 + 1 schedule within the German Statutory Health Insurance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arabidopsis Proteins
  • Child
  • Child, Preschool
  • Cost-Benefit Analysis
  • DNA-Binding Proteins
  • Female
  • Germany / epidemiology
  • Heptavalent Pneumococcal Conjugate Vaccine
  • Humans
  • Immunity, Herd*
  • Immunization Programs*
  • Incidence
  • Infant
  • Male
  • Markov Chains
  • Middle Aged
  • Pneumococcal Vaccines / economics*
  • Pneumonia, Pneumococcal / economics*
  • Pneumonia, Pneumococcal / epidemiology
  • Pneumonia, Pneumococcal / prevention & control
  • Young Adult


  • Arabidopsis Proteins
  • DNA-Binding Proteins
  • Heptavalent Pneumococcal Conjugate Vaccine
  • Pneumococcal Vaccines
  • QALGGH zinc finger protein, Arabidopsis