	Emerging Markets: Growing middle and upper class within many developing countries is creating more opportunity in emerging markets (e.g., BRIC countries) for vaccines that were once considered too expensive or of too small medical benefit

	New Technologies: New vaccine technology is improving existing vaccines (e.g., DNA vaccines, VLP, conjugate, non-animal-derived substrates) and expanding what is possible for new vaccines (e.g., therapeutic vaccines for areas such as prostate cancer, lymphoma, and melanoma)

	Combination Vaccines: The large number of pediatric vaccines, especially for infants under 1 year of age, has created crowding that could make it more difficult to market additional vaccines to this age group. To address this, combination vaccines are increasingly used to minimize the number of “shots.” Yet, combination vaccines have important and significant drawbacks such as financial disincentives and potential greater risk of adverse events

	Public Doses: With rising vaccine costs, governments are become more price sensitive. Fewer US states are fully “Universal Purchase” and/or offer “Choice” in their VFC programs