Vaccine innovation models are typically discussed in terms of isolatable elements, including creation and production, regulation, and distribution, each governed by its own internal logics. This edited volume departs from such approaches by arguing that these elements of the vaccine system are not discrete but fundamentally interrelated. It advances the claim that the effective functioning of vaccine systems depends on understanding the dynamics between these different elements, rather than treating them in isolation. The volume further argues that these dynamics are shaped by prevailing socio-cultural and political-economic conditions. Chapters in this volume, organized into three sections, take one element of the system as their analytical starting point and examine its interactions with other elements, as well as how these interactions are conditioned by broader social contexts. Across eleven chapters, the volume offers insights for policymakers, innovation actors, and public health critics, emphasizing that balancing innovation and public health goals requires moving beyond linear models of innovation that are frequently invoked to justify interventions which are, at best, uneven in their outcomes.