Return on Investment of 10-Valent Pneumococcal Conjugate Vaccine in Ecuador From 2010 to 2030

•This is the first estimate of the return of investment of a vaccine based on Ecuadorian information.•Despite the negative return on investment (ROI) in the introduction year, the cost-of-illness approach yields a positive ROI in the subsequent 2 decades of 10-valent pneumococcal conjugate vaccine immunization.•The ROI shown in this study serves as evidence for decision makers on the benefits of vaccination in terms of economic impact, not only to protect the budget earmarked for pneumococcal conjugate vaccines but to ensure the sustained financing for immunization in the future.