Vaccines in the 21st Century

liver411

Vaccines in the 21st Century

Keith A. Rosenbach, MD, PhD, and T. Sinnott, MD, University of South Florida College of Medicine, Tampa

[Infect Med 18(8s):FV5, 2001. © 2001 Cliggott Publishing Co., Division of SCP/Cliggott Communications, Inc.]



The term "vaccinate" derives from the Latin "vacca" for cow. The practice began in 1796 when Dr Edward Jenner used material from cowpox lesions to "vaccinate" an 8-year-old boy, James Phipps, against smallpox. This landmark in the history of medicine was followed by a second milestone in 1885, when Louis Pasteur vaccinated a 9-year-old boy, Joseph Meister, who had been bitten by a rabid dog.



Today, vaccination is regarded as the most effective strategy for preventing infectious diseases. Multiple vaccines are available, with both live and killed virus types considered safe and effective in the prevention of disease. In this special issue of INFECTIONS in MEDICINE, we are pleased to present a collection of overview articles on various aspects of vaccines and vaccination that are intended to update our readers on this important field. In the first article, Drs David Phelan, Robert M. Jacobson, and Gregory A. Poland provide a review of the routinely used pediatric and adult vaccines, including recommendations for the use of Lyme disease vaccine. Dr Benjamin Estrada presents a vital discussion on the complex vaccine recommendations for children involved in international adoptions, as well their parents- and siblings-to-be. Dr F. Marc LaForce follows with a discussion of the less frequently used vaccines, including those against hepatitis A, rabies, typhoid fever, and meningococcal meningitis. Dr Barbara Watson provides an appreciation of the potential for greater use of vaccines as she summarizes the status of vaccines in the pipeline for prevention of such threats as cytomegalovirus infection, group B streptococcal disease, hepatitis C, HIV infection, human papillomavirus infection, genital herpes, tuberculosis, malaria, and meningococcal disease.



The field of vaccine development is progressing rapidly. Vaccines are being developed to prevent disease from pathogens for which no previous vaccine was available, such as West Nile virus. Existing vaccines are being reformulated to provide easier routes of administration (such as the inhaled influenza vaccine) as well as decrease side effects (such as the rotavirus and diphtheria/ tetanus/acellular pertussis vaccines). Combinations are being developed to decrease the number of inoculations, such as the newly FDA-approved hepatitis A/hepatitis B vaccine. In addition, new concepts in vaccination, including recombinant subunits, reassortment virus techniques, live vectors, and naked DNA technology, are seemingly just over the horizon.



Our strategies for disease prevention must not be limited to new knowledge and new technologies, but must be translated into practice by increasing our vaccination rate. This involves assuring the public of the safety and efficacy of vaccines, providing for widespread distribution of vaccines to eradicate disease on a global level, and continuing support of third world countries that share an unfair burden of infectious diseases.



Dr Rosenbach is assistant professor of medicine, division of infectious diseases and tropical medicine, University of South Florida College of Medicine, Tampa, and director, communicable diseases, Hillsborough County Health Department, Tampa. Dr Sinnott is professor of medicine, surgery, and OB/GYN, and director, division of infectious diseases and tropical medicine, University of South Florida College of Medicine.