Chapter 8 - Vaccine Immunology: What Do Clinicians Need to Know?

Abstract

For much of the history of vaccinology, elucidation of an apathogenic isolate capable of conferring protective immunity to pathogenic exposure was empirical in nature rather than the result of detailed molecular characterization. Recent decades have seen an explosion of knowledge across immunology, microbiology, and genome sequencing, offering unprecedented prospects for rational design of new, much-needed vaccines. Vaccine candidates can be rapidly produced and comprehensively evaluated. Vaccination depends on stimulation of specific immune memory. Adaptive immunity encompasses a diverse arsenal of effector mechanisms, from antibody subclasses and their associated functions to T lymphocyte cytokines and cytotoxicity, these exquisitely evolved for suitability of response to particular invading pathogens. There is growing appreciation that vaccines and the associated adjuvants need to be similarly attuned to the particular flavor of protective immunity that needs to be elicited. Although the field of vaccinology has innumerable victories to celebrate for their impact on public health, several faltering vaccine programs attest to the knowledge gap in how to achieve fully protective immunity upon subsequent exposure.