OBJECTIVES: Routine meningitis C (MenC) vaccination to individuals <18 years has been adopted in the UK since 1999 but is not yet available in Germany. Our aim was to estimate the costs and economic consequences of a routine MenC vaccination programme in Germany for children aged up to 10 years versus no vaccination. A secondary analysis considered a catch-up initiative for individuals aged 11 to 19. METHODS: A published cohort simulation model was adapted. Data to populate the model was obtained from published sources and official statistics. Incidence, mortality, and vaccine efficacy were estimated. Costs included the cost of the vaccination, inpatient management, insurance (benefit) payments to parents, and long-term disabilities. Costs were divided by effectiveness (life years gained) to estimate cost per life year gained. Population estimates were applied to consider the total cost of vaccination. Selecting credible data ranges and statistical distributions, a probabilistic sensitivity analysis was performed on ultra-sensitive parameters to evaluate the effects of multivariate uncertainty and generate 95% confidence limits. RESULTS: The annual cost of the vaccination programme was estimated to be €27.2m, increasing to €59.7m when factoring in the catch-up cohort. Managing infections and long-term costs were estimated to fall by €0.4m and €0.6m, respectively. Routine vaccination was estimated to avoid 6 deaths per year, increasing to 12 deaths avoided including catch-up. Findings were sensitive to disease incidence, vaccine efficacy, mortality and an incidence inflator for under-reporting. Cost-effectiveness was estimated at €64,203 (95% CI: 48,502 – 89,246) per life year gained for the primary analysis and €64,865 (51,130 – 86,412) when including the catch-up initiative. CONCLUSIONS: Our results demonstrate a reasonable level of cost-effectiveness for both vaccination strategies, with a relatively tractable overall impact on the wider health care system. Results are broadly similar to those reported in economic evaluations in other countries.