OBJECTIVES:  The pneumococcal non-typeable Haemophilus influenzaeprotein D conjugate vaccine (PHiD-CV) and the 13-valent pneumococcal conjugate vaccine (PCV-13) are successfully used in many national universal mass vaccinations (UMV) to protect against invasive pneumococcal diseases (IPD), pneumonia and acute otitis media (AOM). Both vaccines are registered in Poland and privately available. For only some children and some young risk groups (eg. preterms), their vaccination is free of charge. New evidence for vaccine effectiveness overrules assumptions from previous cost-effectiveness analysis (CEA) and necessitates an updated CEA with the objective to compare the cost-effectiveness of both vaccines in UMV for children in Poland. METHODS:  A published Markov cohort model was adapted to simulate for both vaccines and from the public payer perspective the long-life epidemiological burden of IPD, pneumonia and AOM for the Polish birth cohort (n=373,527). Only direct medical costs were included and costs and outcomes were discounted annually. Vaccine efficacy assumptions for a 2+1 regime (at 2, 4, and 13 months) were based on most robust published trial data. Local demographic, clinical, epidemiological data and serotype distribution were used. RESULTS:  Under our model assumptions, both vaccines had a similar impact on IPD and pneumonia, but PHiD-CV generated a greater reduction in AOM cases (33,141 cases) and tympanostomy tube placements (6,499 cases). Hence, at parity price, PHiD-CV was dominant over PCV-13 since it returned 177 additional discounted quality-adjusted life years gained and saved PLN 8.5M (discounted) to the public payer. Finally, if the model accounted for a usual 30% lower price of PHiD-CV compared to PCV-13, the cost-saving increased to PLN 57.5M (discounted). CONCLUSIONS:  PHiD-CV is expected to provide both additional health benefits and cost-savings compared to PCV-13, at price parity. Using PHiD-CV could save the public payer a substantial budget which could be used to implement other interventions.