Modern Vaccinology: Progress Towards the Global Control of Infectious Diseases

Abstract

Prevention of disease by immunization predates knowledge of infection or immunology in human history. The inoculation intranasally of smallpox material in 590 BC in an effort to help prevent that deadly disease has undoubtedly been the most memorable event. This paved the way to immunization practices in turn based on literally years of casual but nevertheless labour intensive observations, intuition and scientific experimentation. At the present time immunization practices are for the most part based on immunologic aspects of the host response, the microbiological techniques on hand, restraints of practicality, and to a large extent, on economic, ethical considerations. The elimination in recent years of smallpox does indeed represent the final chapter in a 2500 year history of vaccination that encompasses all the above factors. Most of the existing vaccines appear to be primarily for the prevention or control of acute bacterial or viral infections. Development of vaccines to some chronic diseases, e.g. AIDS and malaria, does however, necessitate a rather detailed knowledge of effective means for the generation of particular immune responses. Studies on model systems seem to be the main sources of such information and additionally provide further insight into the success story of some current vaccines. In AIDS vaccine research, for example, in efforts to create a vaccine conferring sterilizing immunity, monkey experiments using simian immunodeficiency virus have been used as a testbed (Cohen, 1993). The general aspects of the current status of modern vaccinology and hopes for the future are focussed in this editorial.