The rationale for universal use of a prophylactic Epstein-Barr virus vaccine

Epstein-Barr virus (EBV) was discovered in 1964 by examining cells from a malignant tumor under an electron microscope and as such became the first recognized human cancer virus. Shortly after that, EBV was shown to have infected at least 90% of adults worldwide with infectious mononucleosis being the common clinical manifestation of primary EBV infection. EBV is implicated in the causality of a plethora of malignancies and autoimmune diseases. Recent research studies have strengthened these associations. EBV associated diseases are an enormous global health problem and for that reason we are advocating for the universal use of a prophylactic EBV vaccine to prevent or reduce the severity of these EBV diseases. However, we are aware that a number of unanswered questions need to be addressed in order to maximize the potential benefit of such a vaccine. Perhaps the most important of these is whether an EBV vaccine given after primary EBV infection would confer any protection from the chronic sequelae attributed to EBV.