Public health is continually threatened by re- and newly emerging infections, as well as pathogen resistance to available intervention strategies, including vaccines. This persistent threat of the unmet medical need challenges vaccine developers to anticipate future epidemiological outbreaks. Nevertheless, there are insufficient resources available to address all unmet medical needs:  developing the average vaccine candidate from the symbolic ‘bench to bedside’ takes approximately 10 years requiring an investment exceeding €400 million. Furthermore, vaccine development is affected by the so-called innovation paradox. In short; regardless of increasing research and development activities, the predicted output - as measured by successful market entry of the commercialized product - is lacking behind. This situation has intensified over the past few decades and significantly impacts the productivity gap in vaccine valorization. In the view that there is a correlation between health and wealth; it is critical to select the appropriate target disease area for vaccine development. 

This dissertation evaluates the innovation paradox in selecting human infectious disease targets for vaccine development. When it comes to selecting the target, there is a distinction between the level at which the infectious disease is manifested (societal-level), and the level at which valorisation takes place (entrepreneurial- and organizational-level). This action-reaction reciprocity between the micro- and macro-level lies at the heart of the innovation paradox. The six research chapters offer an assessment into entrepreneurial- and organizational-level productivity, focusing on strategies that would potentially stimulate and restrict vaccine target selection. Additionally, we propose the valorization process would be more efficient as an all-inclusive cycle, delineating a number of sequential steps from bench-to-bedside and back again. Such a cycle would allow for proper assessment into the available resources, in order to most accurately determine and address the unmet medical need. Nevertheless, it is up to the biopharmaceutical community to demonstrate their innovative capacity within the context of valorization in order to continue to develop safe and effective vaccines for the benefit of public health