OBJECTIVES: The cost-effectiveness of pertussis vaccination has been demonstrated for various vaccination strategies. However, beyond financial cost expressed in monetary terms vaccines also incur environmental cost expressed in CO2equivalent (CO2e) emission. By preventing disease, this cost might be offset by avoided events such as doctors’ visits, hospital bed stays, medication, amongst other items. In this exercise we examine the CO2e savings of a pertussis (dTpa) booster dose for cocooning in England and Wales. We propose a complementary measure to the classical Incremental Cost-Effectiveness Ratio that includes environmental cost instead of monetary cost. METHODS: The cradle to gate carbon footprint (from raw material extraction, to manufacturing, to disposal) for a typical dTpa vaccine dose was assessed to estimate the total amount of CO2e emitted (“carbon cost”). A previously published static epidemiological model was used to account for the reduction in incidence of pertussis. Two scenarios were compared: the current pertussis vaccination schedule and the same schedule with additionally a cocooning strategy. RESULTS: For each dose of a dTpa vaccine manufactured, results show approximately 1kg of CO2e was emitted. The model shows cocooning immunization against pertussis is projected to reduce the reported incidence of pertussis in young infants. Results also show that due to the reduction in emitted CO2e after the introduction of a cocooning strategy, vaccination is an acceptable alternative to the current strategy to control pertussis infection. CONCLUSIONS: The method presented demonstrates how traditional economic models can be utilized to model environment features. Assessment of the cradle to gate carbon footprint of a vaccine provides a preliminary view of both the impact on the environmental in general and on the environment profile of health care in the UK.