RT Book, Section A1 Rodrigues, Charlene M.C. A1 Handy, Lori Kestenbaum A1 Haynes, Barton F. A1 Plotkin, Stanley A. A2 Boulton, Matthew L. A2 Wallace, Robert B. SR Print(0) ID 1182675367 T1 Vaccine Innovation and Development T2 Maxcy-Rosenau-Last Public Health & Preventive Medicine, 16e YR 2022 FD 2022 PB McGraw Hill PP New York, NY SN 9781259644511 LK accessmedicine.mhmedical.com/content.aspx?aid=1182675367 RD 2024/04/23 AB Vaccine manufacture began in humble academic laboratories such as that of Louis Pasteur in the Rue d’Ulm in Paris1 or on the cow farms in which vaccinia was produced.2 The results of vaccine application hardly needs emphasis, and numerous data testify to the impact of vaccination with regard to disease incidence, mortality, and economics.3–8 However, by the beginning of the twentieth century, it was obvious that a large number of doses was needed and that standardization was necessary. At first this was accomplished in government laboratories but soon the scale of effort exceeded the personnel and facilities, and also the possibility of profit became evident, so that manufacture passed to pharmaceutical laboratories. These were concentrated in Europe and the United States. After the Second World War, when the number of routine vaccines increased, lawsuits against vaccine manufacturers began to increase sharply. The result was the withdrawal of some manufacturers from the vaccine field, and the contraction of the industry to four major players: GlaxoSmithKline, Merck, Pfizer, and Sanofi.