Vaccines and vaccination strategies

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Abstract

Development of viral and conjugated bacterial vaccines have decreased and in some cases eradicated diseases that used to cause significant morbidity, mortality, and sequelae in individuals of all ages. Expanded Programs on Immunization practices throughout the world have been one of the most successful medical interventions in history. The symposia on vaccines comprised a vision for the future of human papillomavirus (HPV) and herpes zoster (HZ); current options and future prospects for meningococcal disease prevention; advanced viral vaccines for a healthier future such as those for influenza, smallpox, hepatitis A and varicella; current concepts on yellow fever epidemiology and prevention; findings of the Global Pertussis Initiative and; current recommendations for the global eradication of polio. The symposia, largely comprised of speakers and delegates working in clinical studies and in industry, focused on epidemiological data to measure the success and needs of old and current strategies and new vaccine programs. In most cases a consensus emerged regarding the problems facing the fields, most importantly, recommendations emerged regarding the most appropriate approaches per country or per region. Priority country or region issues were a hallmark of all symposia as well as a rationale for the introduction of new vaccines and coverage of all age groups in some instances. The symposia on vaccines gave an enlightening view of the clinical experience with old and new vaccines and their current recommendations for people of all ages. Innovative research in disease prevention: a vision for the future on human papillomavirus & herpes zoster This symposium was held on 5th March and was chaired by Elaine Esber of Merck & Co. Inc. (PA, USA); Allan Ronald (Winnipeg, Canada), and Richard Whitley of the University of Alabama at Birmingham (AL, USA). The speakers were Nubia Muñoz (IARC, Lyon, France); Robert Johnson from the University of Bristol (UK), and Myron Levine of the University of Maryland Medicine (MD, USA). According to Dr Munoz, at least 50% of sexually active adults have had genital HPV. There are more than 100 genotypes of HPV and approximately 40 have been implicated in infections of the genital tract; most are transient and 20% go on to persistent infection. In the year 2000 the highest incidence of cervical cancer was reported from Africa, Latin America, Western Europe and North America. Strategies targeted at prevention include screening programs, however, in developing countries these are deficient or missing; in these situations a way to circumvent these limitations would be vaccination. Vaccine studies carried out in Colombia, Peru, Paraguay, Mali, Morocco, Thailand, The Philippines and Spain showed a significant reduction in HPV in vaccinees versus controls, odds ratio of 248.0–434.5 for cancer types 16 and 18, and of 63.0–276.8 for the less common types. It is most important to pay attention to the prevalent types of cancer in each geographical region in order to predict the