Palmu AA, et al. - The pneumococcal disease burden was determined by using the vaccine-preventable disease incidence (VPDI) of a 10-valent Pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10 vaccine, GSK) in the Finnish Invasive Pneumococcal disease (FinIP) trial. Over 95% of the disease episode reductions were seen in mild upper respiratory infections in vaccinated children examined in a European developed-country setting. Since routine blood-culture-based definitions failed to detect most of the invasive disease, the VPDIs of severe diseases were underestimated. It was considered crucial to assess the absolute reduction achievable with vaccinations using sensitive case detection in order to understand the full disease burden, to perform valid cost-effectiveness analyses and to make appropriate vaccination policy decisions.