OBJECTIVES: Our goal was to estimate the minimum cost for achieving vaccine research and development (R&D) preparedness targets in a portfolio of 11 EIDs, accounting for vaccine pipeline constraints and uncertainty in R&D preparedness outcomes.

METHODS: We assembled a pipeline of 224 vaccine candidates from preclinical through phase II for 11 priority EIDs. We used a linear regression model to predict development costs from preclinical through end of phase IIa. Drawing from published estimates of vaccine R&D Probabilities of Success (PoS), we simulated costs for advancing a portfolio of 224 vaccine candidates through end of phase IIa. We used these findings to determine minimum costs for progressing at least one vaccine though end of phase IIa per EID, through a stochastic optimization model.

RESULTS: The cost of developing a single EID vaccine from preclinical through end of phase IIa is US$ 58–97 million (US$33–130 million range). Previous licensure experience and indirect costs are upward R&D cost drivers. Accounting for PoS, the cost of advancing an EID vaccine through phase IIa can range from US$0·1–0·2 billion (starting from phase II) to US$0·5–0·8 billion (starting from preclinical). Zika, Ebola, Chikungunya, Middle East respiratory syndrome–related coronavirus, Rift Valley Fever, Marburg, and Lassa have sufficient vaccine pipelines for investments in these to guarantee at least one phase IIa outcome. An additional 18 to 55 preclinical candidates would ensure a minimum phase IIa outcome for Nipah, Crimean Congo Haemorrhagic Fever, Severe Acute Respiratory Syndrome, and Severe Fever with Thrombocytopenia Syndrome. Progressing at least one vaccine through end of phase IIa for each EID would cost a minimum of US$4·3–6·7 billion.

CONCLUSIONS: Our analysis provides new evidence on vaccine R&D pipelines and associated costs for 11 EIDs, highlighting both funding needs and R&D gaps for achieving vaccine R&D preparedness targets.