In a systematic review of economic evaluations, Gharpure and team examine the costs of influenza illness and vaccination programs in low- and middle-income countries to assess potential barriers to global implementation. Full length: In this systematic review of economic evaluations, Radhika Gharpure and colleagues examine the costs of influenza illness, the costs of influenza vaccination programs, and the cost-effectiveness of vaccination from low- and middle-income countries to assess whether gaps remain that could hinder global implementation of influenza vaccination programs.