We assessed the cost-effectiveness of offering catch-up vaccination with Bexsero 
against meningococcal disease to children too old to receive the vaccine under 
the recently introduced infant programme. Offering catch-up vaccination to 
increasingly older children is less economically attractive because of declining 
disease burden. We estimate catch-up vaccination of 1year old children could be 
cost-effective, incremental on the infant programme with a vaccine price of ⩽£8 
per dose. Extending vaccination to 2year olds could only be cost-effective 
(incremental on infant and 1year old catch-up) with a vaccine price of ⩽£3 per 
dose and was not cost-effective in sensitivity analyses with more conservative 
vaccine assumptions. Extending catch-up further to 3-4year olds was not 
cost-effective. Employing the current criteria for assessing vaccines, our 
models suggest that even with low vaccine prices only catch-up vaccination in 
1year old children could be cost-effective, when considered incrementally on the 
infant programme.