In non-mandatory vaccination policies, individual choice can be a major driver of vaccine uptake. Choice thereby influences whether public health targets can be achieved. Individual vaccinating decisions can be influenced by perceptions of vaccine risks or infection risks. There is also the potential for non-vaccinators to strategically 'free-ride' on herd immunity provided by vaccinators. This strategic interaction between individuals generates a social dilemma - a conflict between self-interest and what is best for the group as a whole. Game theory and related mathematical approaches that couple mechanistic models of vaccinating decisions with mechanistic models of disease spread can capture this social dilemma and address relevant questions. The past decade has seen significant growth in the theoretical literature developing and analyzing such models. Here, we argue that using these models to address specific public health challenges will require more work that integrates information from empirical studies into the development and validation of such models, as well as more collaboration between mathematical modelers, psychologists, economists and public health experts. © 2012 Landes Bioscience.