Fig. 1

Decision Tree diagram. At the square decision node, identical hypothetical cohorts of high-risk 18–64 year olds could receive the implementation program or not. Nodes to the right of brackets are connected to all branches to the left of brackets. At each circular chance node, potions of cohorts could receive vaccines, become ill with influenza, pertussis, and/or pneumococcal disease, with or without complications, based on the 10-year probability of those events. Disease probabilities were based on vaccines received and vaccine effectiveness. IPD = invasive pneumococcal disease; NBP = non-bacteremic pneumococcal pneumonia