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British Medical Bulletin 62:1-13 (2002)
© 2002 The British Council

Overview of vaccines and immunisation

Myron M Levine, James D Campbell and Karen L Kotloff

Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland, USA

The first 150 words of the full text of this article appear below.


   The biotechnology revolution
 
During the past two decades, advances in biotechnology and increased knowledge of the inductive and effector components of immune responses have revolutionized the field of vaccine development. This has opened a vaccine 'pipeline' that has already resulted in the licensure of many new and improved vaccines including recombinant hepatitis B vaccine, acellular pertussis vaccines, and conjugate vaccines against Haemophilus influenzae type b, group C Neisseria meningitidis and Streptococcus pneumoniae. The application of recombinant DNA technology, polymerase chain reaction amplification, monoclonal antibodies, peptide synthesis, genomics (in particular, the sequencing of the entire genome of various pathogens1), proteomics and high throughput informatics are examples of the powerful tools driving the development of desirable new and improved vaccines2. Combined with advances in adjuvant technology, specific methods of modulating immune responses (e.g. by the administration of various cytokines), and novel ways of delivering antigens, many interesting new vaccine candidates and . . . [Full Text of this Article]


   The vaccine development paradigm
 
Phase I trials

Phase II trials

Experimental challenge studies

Phase III trials

Phase IV trials


   Some undercurrents influencing the flow of vaccine development
 
Societal perceptions and expectations of vaccine safety

The 'busy' infant/toddler immunisation schedule

The desirability of administering vaccines by non-parenteral routes

Economics and vaccine development

Global market vaccines
Industrialised market vaccines
Impeded vaccines
Developing market vaccines
Fostering the development of 'impeded' vaccines

Vaccines against chronic diseases

Target populations for vaccination other than infants and toddlers

The Global Alliance for Vaccines and Immunization (GAVI)

Globalization

Generic 'platform' technologies in vaccine development

Bioethical issues in vaccine development


   Concluding comments
 

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