OBJECTIVES: To systematically review economic evaluation studies of vaccination programs in China. METHODS: We did a computerized search of published full economic evaluations of Chinese vaccination programs (published prior to March 16, 2014) in major English and Chinese databases. RESULTS: Seventeen economic evaluations of 8 vaccines were identified, and Hepatitis B vaccine (29%) and 7-valent pneumococcal conjugate vaccine (18%) were the most studied. All studies were model based, but half of them used simple decision tree. 59% adopted a societal perspective. Eleven (65%) studies used a lifetime time horizon. 71% used the 3% discounting rate for base case analysis, and 24% either did not discount health outcomes or cost, or did not explicitly report the discounting rate. Effectiveness and cost data in 88% and 41%, respectively, were from literature alone. All 8 studies with QALYs outcome used utility data from other studies, of which only one used utilities generated in Chinese population. 29% of those with composite outcomes DALYs and QALYs included cases, deaths and life years at time. 47% considered indirect cost due to causes such as sick leave and loss of productivity in addition to direct cost for the analysis. All but one studies included sensitivity analysis, but 53% did not conduct probability sensitivity analysis to see the joint effect of uncertainties around multiple parameters. Six (35%) were post hoc studies assessing the cost-effectiveness of current vaccination compared with the non-vaccination alternative. All studies except one on 7-valent pneumococcal conjugate vaccine showed cost-effectiveness for the vaccinations. CONCLUSIONS: Major methodological flaws and reporting problems exist in economic evaluations for vaccines in China. Local guidelines for good practice and reporting are demanded in addition to institutional mechanisms and education for improve the overall quality of economic evaluation work for immunization programs in China.