Viral vaccines and antivirals: current use and future prospects

The evolution of viral vaccines from the time of Jennerian prophylaxis to today's recombinant technology has been a continuing story of success. From the relatively crude or "first generation" vaccines for smallpox, rabies, and yellow fever followed a second and third generation of improved or new viral vaccines. The application of techniques for attenuating, inactivating, and partially purifying candidate viruses yielded safe, effective vaccines against influenza, poliomyelitis, measles, mumps, and rubella. With the advent of effective national immunization programs in the United States and other areas of the world to promote wide scale use of these vaccines, we have seen a dramatic decrease in incidence of the viral infections of childhood. The new biotechnology serves as the cornerstone for a fourth generation of vaccines and has already provided a licensed recombinant yeast human hepatitis B vaccine. The prospects for a wide spectrum of new or improved vaccines are highly encouraging, not only because of the recent technical advances but also because vaccine development has been recognized as a priority area of research. Under the National Institute of Allergy and Infectious Diseases' Program for Accelerated Development of New Vaccines, support is being provided for developmental vaccine studies with hepatitis A and B, influenza A and B, rabies, rotavirus, varicella, and respiratory syncytial virus (53). The outlook for antivirals is equally optimistic. The same technologies that have provided greater insight into the genetics and molecular biology of viruses and hence the means to fashion subunit or even synthetic vaccines have yielded data that can be applied to successful development of targeted antiviral compounds.