Plant-Made Vaccines Targeting Enteric Pathogens-Safe Alternatives for Vaccination in Developing Countries

Enteric diseases by pathogenic organisms are one of the leading causes of death worldwide, particularly in low-income countries. Despite antibiotics, access to clean water and vaccination are the most economically affordable options to prevent those infections and their health consequences. Vaccines, such as those approved for rotavirus and cholera, have played a key role in preventing several enteric diseases. However, vaccines for other pathogens are still in clinical trials. Distribution and cost remain significant barriers to vaccine access in developing regions due to poor healthcare infrastructure, cold-chain requirements, and high production costs. Plant-made vaccines offer a promising alternative to address these challenges. Plants can be easily grown, lowering production costs, and can be administered in oral forms, potentially eliminating cold-chain dependency. Although there are some promising prototypes of vaccines produced in plants, challenges remain, including yields and achieving sufficient immunogenicity. This review aims to describe common enteric pathogens and available vaccines, followed by a strategic summary of plant-made vaccine development and a discussion of plant-made enteric vaccine prototypes. Trends to overcome the key challenges for plant-made vaccines are identified and placed in perspective for the development of affordable and effective vaccines for populations at the highest risk of enteric diseases.