Sensitivity of strategy optimality to canine vaccine efficacy. The probability that each strategy is optimal across a range of cost-effectiveness thresholds was evaluated for an alternative canine vaccine efficacy of 80% (base case: 100% vaccine efficacy). Rabies programs evaluated include maintenance of the status quo (gray lines), expanding targets for canine vaccination alone (CV; blue lines of progressively deeper shades), and expanding targets for combined canine vaccination and female sterilization (CVFS; red lines of progressively deeper shades). Canine vaccination with sterilization of both males and females is never optimal and is not shown here. The vertical dotted and dashed lines indicate the WHO thresholds for very cost-effective and cost-effective strategies in India ($1,582 and $4,746 per DALY), respectively.