Cost-Effectiveness Analysis of Universal Influenza Vaccination: Application of Susceptible-Infectious-Complication-Recovery Model.

•A cost-effectiveness analysis (CEA) of an influenza vaccination program was performed using dynamic and static models.•The new mathematical epidemiological model overcomes unobservable infection states.•Models that do not consider herd immunity severely underestimate the cost-effectiveness of the influenza vaccine.•These results are important for policymakers in developing countries with limited vaccine availability.