10). WHO polio position paper “Prior to polio eradication, national immunisation schedules should include either oral polio vaccine, inactivated polio vaccine, or a combination of both. Vaccine decisions should be based on assessments of the potential for importation of wild poliovirus (WPV) and subsequent transmission. High immunisation coverage is essential to ensure adequate population immunity. As long

as WPV transmission has not been interrupted everywhere, all polio-free countries and areas remain at risk of re-importation, particularly from the remaining polio-endemic countries. Source: WHO (2010) Polio immunisation see more opened the door to other live, attenuated virus vaccines, such as those against measles, mumps, rubella and varicella. In the 1970s, a combined measles-mumps-rubella (MMR) vaccine was developed to minimise the total number of injections in infants. Data from clinical trials with MMR demonstrated that a combination of antigens could be administered safely and effectively. Despite many significant advances, the attenuation of pathogens was still based largely on empirical observations of virulence. A more targeted attenuation would not become possible until advances Selleck BMS354825 in molecular biology allowed virulence determinants to be specifically targeted for deletion or disruption.

Whole organism vaccines for pathogens, such as influenza or pertussis, presented barriers to acceptance due to their reactogenicity Sulfite dehydrogenase profile, eg up to 20% of vaccinees receiving the original form of whole inactivated influenza vaccine developed fever and malaise. The pertussis vaccine caused high rates of fever and was alleged to cause some cases of encephalitis in children. This was subsequently shown to be unsubstantiated, but there was a loss of

public confidence and reduced vaccination coverage. These safety concerns prompted research on other approaches to the production of safer and more effective vaccines. The need for new technologies to develop new vaccines When developing new vaccines, the most direct approach (which in general involves the whole pathogen) will be used unless there are overriding safety, immunogenicity or practical reasons that make this impossible. In such instances, alternative strategies are employed, such as purified, recombinant or conjugated antigens in conjunction with adjuvants, or the use of novel delivery systems. Vaccine technology in the late 20th century evolved from growing and producing pathogens on a large scale in cell culture to defining and selecting protective antigens. Antigen purification was historically initiated with the manufacture of split influenza vaccines, whereby the influenza vaccine was treated with a solvent to dissolve or disrupt the viral lipid envelope. In the 1970s, the first split influenza vaccines were produced using these fragmentation and purification techniques.