What does it take to develop a vaccine? This paper explores the technical and institutional conditions that allow reliable knowledge to build up in a series of structured stages from the laboratory to the field. The paper highlights the role of instrumentalities (instruments, skills and organisational capabilities) in allowing iteration between these stages; and shows how instrumentalities can be influenced by their institutional context, so that the resulting knowledge grows in a cumulative rather than fragmented manner.

By explaining the historical importance of instrumentalities in polio vaccine development efforts, this paper highlights key features of technological change that are missed in current policy debates focussed on addressing market failure or poorly funded science.