This landscape analysis aims to present a current picture of the global vaccine ecosystem from the purchaser (country) and supplier (manufacturer) perspectives to help global, regional and country stakeholders understand the current distribution of global manufacturing and procurement for different markets, technologies and regions. Using data reported in 2023 from 204 countries and 98 vaccine manufacturers, the report broadly addresses the following questions. 1. What is the geographic distribution of vaccine manufacturing across all production stages at the regional level? What trends are emerging? 2. How is regional manufacturing related to supply security and pandemic preparedness? What can be learned from different regions’ and countries’ experiences? 3. How do links among manufacturers across production stages affect supply security? 4. What is the geographic distribution of vaccine technology platforms? Drawing on the insights generated through the analysis, the report concludes with a discussion of broader strategic considerations surrounding regional vaccine manufacturing. These include the distinction between local and regional production capacity and their respective implications for supply security; the opportunity for regions initiating manufacturing efforts to pursue public investments that strengthen access outcomes; and the critical importance of an enabling ecosystem to ensure the sustainability and success of regional manufacturing initiatives, while monitoring for potential externalities affecting global vaccine access.