Designing Tomorrow's Vaccines

V accines are among the most effective interventions in modern medicine. Ever since Edward Jenner's first use of a vaccine against smallpox in 1796 (see text box), the use of vaccines has become indispensable to the eradication of disease. In the 20th century alone, smallpox claimed an estimated 375 million lives, but since 1978, after the completion of a successful eradication campaign, not a single person has died from smallpox. Today, more than 70 vaccines have been licensed for use against approximately 30 microbes, sparing countless lives (Fig. Diseases including poliomyelitis, measles, mumps, rubella, and others caused an estimated 39 million infections in the 20th century in the United States, but vaccines have since rendered them uncommon (Table he success of this public health intervention emanates not only from the identification of effective vaccines but also from a robust infrastructure for vaccine manufacturing, regulatory and safety oversight, and organized approaches to delivery. Vaccines represent the least expensive and most facile way to protect against devastating epidemics. Society derives economic benefits by preventing hospitalization, avoiding long-term disability, and reducing absence from work. In brief, vaccines provide the most cost-effective means to save lives, preserve good health, and maintain a high quality of life.