Haemophilus influenzae has been a major cause of infectious diseases in children and has been attributed as a significant cause of septic arthritis and osteomyelitis in children. With the advent of widespread vaccination, the incidence of Haemophilus influenzae meningitis and other infections has been well documented. This is thought to be the first report that documents the effect of vaccination on bone and joint infections. One hundred sixty-five cases of acute hematogenous osteomyelitis or septic arthritis treated at the Department of Orthopaedics at Vanderbilt University in the years before and after the advent of the Haemophilus influenzae vaccine to assess whether vaccination affected the incidence of these diseases. The data indicate that the Haemophilus influenzae vaccine has reduced to near 0 the incidence of bone and joint infections because of Haemophilus influenzae. These findings suggest that coverage of Haemophilus influenzae as part of the empiric antibiotic coverage may be no longer needed in the management of acute hematogenous osteomyelitis and septic arthritis in children.