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Abstract
Oral vaccines, whether living or non-living, viral or bacterial, elicit diminished immune responses or have lower efficacy in developing countries than in developed countries. Here I describe studies with a live oral cholera vaccine that include older children no longer deriving immune support from breast milk or maternal antibodies and that identify some of the factors accounting for the lower immunogenicity, as well as suggesting counter-measures that may enhance the effectiveness of oral immunization in developing countries. The fundamental breakthrough is likely to require reversing effects of the 'environmental enteropathy' that is often present in children living in fecally contaminated, impoverished environments.
Highlights
Vaccines represent the epitome of a preventive strategy to control disease [1,2]
The special advantages of oral vaccines Oral vaccines are attractive for immunizing populations in developing countries for several reasons
Contaminated needles and syringes are major problems both for health workers and for environmental safety in many developing countries where there is a high prevalence of HIV and hepatitis B and C [16,17,18]. Because they obviate the need for needles and syringes, oral vaccines allow less qualified health workers to carry out immunization
Summary
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