OBJECTIVES: Cost-effectiveness studies using local health data have supported the long-term health and economic benefits of the 7-valent pneumococcal conjugate vaccine (PCV-7) due to herd immunity, which also led to its inclusion in the routine immunization programme for infants in Hong Kong in September 2009. The aim of the present study is to assess the clinical and economic impacts of the new PCV-13 vaccine on the whole population of Hong Kong compared to no vaccination. METHODS: A decision analytical model modified from the recent Prevenar 13Ò Economic Impact (PREVENT) Model (RTI Health SolutionÒ) was used for the analysis of the outcomes of vaccination. The whole population of Hong Kong of around 7 million was analyzed with infants ≤ 2 either vaccinated or not vaccinated with PCV-13. Population data, incidence rates, serotype coverage, disease sequelae, mortality rates, vaccine effectiveness, duration of protection, herd effects, utilities, cost of vaccination, and other direct costs were adopted from local published studies, previous economic assessments of PCV-7/PCV-13 and local government sources to populate the model. Data were adopted from overseas published studies if local data was not available. Sensitivity analyses were performed to check the robustness of the results. The time horizon was one year and the study was performed from a public health care organization perspective. RESULTS: Over 1 year, our analysis shows for a 4-dose regimen of PCV-13: a gain of 17 quality-adjusted-life-years (QALY), an avoidance of 1,281 related illnesses and 2 deaths. Cost/life-year gained was US-145,014 and cost/QALY was -US161,127. CONCLUSIONS: Based on the WHO recommended international thresholds for cost-effectiveness, with GDP per capita of Hong Kong being US29,902 in 2009, our study results suggest PCV-13 vaccination is very cost-effective in providing protection to the people of Hong Kong from the perspective of a public health care organization.