The group is facing a mountain of difficult challenges and questions. As Feldman points out, the literature on vaccines is scant, public understanding of risk is spotty, the manufacturing costs are high, and the financial incentives are few. And there is a direct correlation between low rates of immunization and high rates of vaccine-preventable illness and death.

Feldman, along with his colleagues at Penn, Columbia, and Tokyo, is bringing together scholars, government officials, experts from international agencies, corporate representatives, and scientists to work toward reaching a consensus on developing sensible standards that govern the entire life cycle of vaccines. As Feldman puts it, “We are asking a range of questions around which there are widely divergent and sometimes intensely opposing views. Which vaccines should be mandated? For whom? Who pays? How should societies balance the incremental improvements in public health that accompany vaccination with the attendant increases in harm to some individuals that will inevitably occur? And how much risk is too much, even if the underlying benefits of vaccination are clear?”