Vaccines in the 21st century

Abstract

The control of infectious diseases through immunization is hailed as one of the greatest medical advances. This is evident by the dramatic decrease in the number of vaccine-preventable diseases, the number of averted deaths, and the overall increase in health and well-being throughout the world. Therefore, it is appropriate that an entire issue of the Immunology and Allergy Clinics of North America be devoted to the impact of vaccines and vaccine practice, as they are invaluable to the practicing internist, allergist, and immunologist. In this issue, I hope to accomplish three major tasks. The first is to provide upto-date information that is directly relevant to the practicing internist and allergist, including diagnosing, preventing, and treating allergic reactions to vaccines. The second task is to discuss specific vaccines of significance in the 21st century; hence, this issue also emphasizes vaccines that prevent diseases due to biologic agents of mass destruction, namely smallpox and anthrax. The third and final task is to discuss specific vaccines and adjuvants that are not necessarily new but merit attention nonetheless. For example, the live, cold-adapted influenza vaccine has resulted in new formulations and methods of administration that may be new to some readers. In addition, this issue provides information on vaccines that may be less familiar to practitioners (eg, the meningococcal vaccine). Furthermore, new concerns over disease epidemiology and hypothesized side effects, such as aluminum inclusion macrophagic myofasciitis, are both topics that deserve attention. The first article focuses on the specific issues of vaccine allergy, diagnosis, and management. The next five articles deal with specific vaccine management topics such as immunization of immunocompromised persons, immunization of egg-