In this study, a simulation model was used to assess the epidemiological and economic impacts of the routine vaccination strategy for H5N1 in China at the national level. The results of the simulation show that a routine vaccination strategy at the national level could have a substantial impact on decreasing H5N1 outbreaks; it could therefore markedly reduce the severity and duration of an H5N1 epidemic at the national level in China. Under a routine vaccination programme, when a flock is infected, the number of depopulated birds could be reduced by approximately 91%, the outbreak duration could be reduced by one-fourth, and the probability of an H5N1 outbreak could be reduced to 51.5%. Although the use of vaccination has obvious benefits, if indirect costs were not considered, the mean direct cost of simulated disease control without vaccination was only 1.36% of the cost of the routine vaccination strategy, and this former approach would have saved 57 billion yuan for all poultry in China from 2004 to 2012. Traditional H5N1 control strategies with culling programmes at the national level represented a better choice for China.