Vaccines have saved an estimated 500 million lives around the world since Edward Jenner discovered how to prevent smallpox infection in 1796. But a successful vaccine roll-out is about more than just medicine; it encompasses engineering, economics, policy, government and even transport infrastructure. More than a decade into the 21st century, and with a new outbreak of the Ebola virus claiming thousands of lives in Africa, does a successful strategy for creating and delivering new vaccines require a whole new approach?