Okafor CE, et al. - This research sought to inform the decision of health policymakers of eight sub-Saharan countries, who are yet to introduce the rotavirus vaccine as of Dec 31, 2020, on the health economic consequences of the introduction of the vaccine in terms of the costs and benefits. Researchers conducted a cost–benefit analysis using a simulation-based decision-analytic model for children aged younger than 1 year, who were followed up to 259 weeks, in the Central African Republic, Chad, Comoros, Equatorial Guinea, Gabon, Guinea, Somalia, and South Sudan. Data were collected and analyzed between Jan 13, 2020, and Dec 11, 2020. The primary endpoint included disability-adjusted life-years averted, converted to monetary terms. Rotavirus gastroenteritis averted and rotavirus vaccine-associated intussusception were considered secondary endpoints. In all eight countries, introducing the rotavirus vaccine, but with caution in Equatorial Guinea and Gabon, would be worthwhile. According to the findings, with the narrow BCR for Equatorial Guinea and Gabon, cautious, pragmatic, and stringent measures need to be employed to ensure optimal health benefits and cost minimization of the vaccine introduction. In addition, the final decision to introduce the rotavirus vaccine should be preceded by matching its BCR to the BCRs of other healthcare projects.