Health Outcome and Cost Models
All vaccination policies considered led to reductions in influenza cases and mortality compared
to policy 0 (no childhood vaccination) (Table 5). The largest reductions were seen with policy 3
(vaccinating children aged 2–17 y with LAIV), and the smallest with policy 7 (increasing TIV
coverage in those aged 60 y to 66%). None of the policies were cost-saving. The largest incremental
costs were seen with policy 3, and the lowest with policy 7. Summarizing these results
on the cost-effectiveness plane shows that all seven policies have a very high probability of
being highly cost-effective at the WHO-recommended threshold (cost per DALY averted less
than gross domestic product per capita [44]) compared with policy 0 (Fig 3A). There was, however,
large uncertainty in the health benefits of vaccination. In part, this was explained by large
annual variation in influenza dynamics.