A vaccine against Asian schistosomiasis: the story unfolds

The development of an effective vaccine against the Asian schistosome is at a critical stage. Despite the fact that progress has been relatively slow, the successful use in animals of attenuated vaccines combined with recent encouraging results using defined native and recombinantly derived Schistosoma japonicum antigens, suggests that development of a safe and effective vaccine is feasible. This review examines current progress aimed at achieving this objective, and a summary is provided of recent results obtained with the most encouraging vaccine antigens. When available for wide-scale use, it is envisaged that the vaccine would be applied in the first instance, at least in China, in the veterinary context (to impact on human transmission) and then, perhaps, if required, clinically (to prevent or reduce disease). The search for the final product is likely to be demanding, and funding issues pertaining to Good Manufacturing Practice-scale-up of the vaccine for the required extensive veterinary coverage, and to support any future human trials, will need to be resolved. As such, we may still have to wait some time before the ultimate vaccine, possibly comprising a cocktail of several molecules, is available. Even then, the vaccine would probably be used optimally as one component of an integrated programme of schistosomiasis control that would include effective and well-tested approaches, such as health education and targeted chemotherapy.