This study assessed the costs and benefits of introducing routine varicella vaccination to healthy children in Germany. Three vaccination strategies were compared with that of no prevention: vaccination of all 15-month-old children: vaccination of susceptible 12-year-olds (adolescent); and a combination of strategies (children including catch-up). From a purely economic viewpoint, the adeolescent strategy was optimal: It was the only one that resulted in net direct cost savings. However, since this strategy may be less acceptable from a medical or organizational point of view and because total net savings were the highest, a second option was to begin immunization starting with the 15-month-old children and to use the catch-up strategy for 11 years (total benefit-to-cost ratio (BCR), 4.72:1; cost-effectiveness ratio (CER), DM 6915 per life-year saved) and from year 12 on to use the first strategy (BCR, 4.60:1; CER, DM 19,735 per life-year saved).