Objective: To assess the availability of decision tools, providing a standardized basis for rational decision making on vaccine introduction.

Methods: Systematic literature review, supplemented by hand-search and contact with immunization experts, comparison of key documents and discussion of relevant criteria.

Results: Five key documents providing an analytical framework or key questions aiming at rational decision making were found. A comparison of these documents revealed an overall similarity with some differences in the approach as well as the criteria.

Conclusion: Assuming that the most comprehensive framework possible would not provide a feasible tool for decision makers, a stepwise procedure has been suggested. Comments, examples and caveats have been given for each step to provide a basis for further discussions. The observed lack of standardized measures, defined cut-off points and comparable weighing of included criteria currently hinder rational decision making.