One vaccine shot was assumed at ¥8,116 (US$ 74: US$1 = ¥110) for PPSV–23 and ¥10,776 (US$98) for PCV–13, which were the sum of vaccine price (¥4,737 or US$43 for PPSV–23, ¥7,200 or US$65 for PCV–13) [28, 29], doctor fee and technical fee for PPSV–23 and PCV–13, respectively.