Chapter 11. Vaccines

Summary

During the past century, society has seen significant progress in public health. A child born in the United States one hundred years ago had a life expectancy of 47 years. Today, the same child would be expected to live 30 years longer. Together with clean water, the availability of safe and efficacious vaccines has been the most significant factor contributing to the increase in life expectancy and to the quality of life. The eradication of smallpox in the 1970's stands as one of the crowning achievements of global public health efforts in the 20th century. At the beginning of the 21st century, polio is on the verge of global eradication. Once-common childhood diseases, such as mumps, measles, and rubella, have been brought under control in most parts of the world. The majority of these victories have been achieved with only a handful of “conventional” approaches, including live attenuated vaccines, whole-killed vaccines, and subcellular or subunit vaccines. Recent advances in molecular biology, immunology, genomics and proteomics, and drug delivery technologies, are already having major impact on experimental vaccines, both in terms of how they are designed and delivered and how they are used. This chapter addresses the questions of why vaccines are important and how they work, and discusses the basic principles employed by traditional vaccine approaches and the distinguishing features of subcellular and recombinant vaccines. Beyond their traditional role as protective agents against infectious diseases, vaccines of the future are likely to find use as therapeutic agents against cancer and other non-infectious diseases.