The process of ranking vaccines in order of desirability by using the health benefit, expenditure, and other information developed with this method depends on the ultimate goals of the exercise and constraints that limit the number of candidates that may be selected. The committee proposes that the potential global health benefit of a vaccine take precedence in determining its initial ranking for accelerated development priority. The affordability of benefits, represented by the relevant expenditures on vaccine, can also be introduced into the decision process, if desired. This is illustrated in Chapter 9 where the effect on the health benefit rankings of various levels of constraint on financial resources is examined.
Chapter 3 provides a detailed description of the procedures that can sometimes be used to establish priority rankings if two equally important selection criteria are used. These are based on the concept of dominance: if a vaccine candidate is more desirable than another on one dimension (either potential health benefits or expenditures on vaccine—lower is preferable) and at least as good on the second dimension, then it dominates the other candidate.
Chapter 8 identifies some additional issues that should be considered in the final selection of priorities for accelerated vaccine development. These include the distribution of benefits from new