Closing the Gap: Advances and Barriers on Candida Vaccines Development in the Last Decade

Invasive Candidiasis (IC) remains a critical threat to global health. Primarily caused by Candida albicans, it is increasingly driven by emerging Non-Candida albicans Candida Species (NCACs). IC typically arises from the overgrowth of commensal Candida species in immunocompromised hosts. IC accounts for an estimated 250,000-700,000 cases annually worldwide, with mortality rates between 40 and 55%, and contributes to more than 1.5 million annual deaths. Despite progress in healthcare systems, intensive care, and microbiological techniques, mortality rates remain largely unchanged. Triazole resistance is already widespread, and echinocandin resistance, while still low, is steadily climbing. The emergence of multidrug-resistant Candida auris, the growing immunocompromised population, and the absence of any antifungal vaccine collectively define this scenario as a therapeutic impasse. Given these challenges, there is an urgent need to synthesize current vaccine research to identify robust candidates and address lingering translational bottlenecks. This structured narrative review evaluates the advances and barriers in Candida spp. vaccine development over the past decade (2015-2025), structured around epidemiology and resistance; immunological framework underpinning vaccine design; antigenic targets and delivery platforms; and preclinical and clinical evidence. Key milestones included the Phase II clinical validation of NDV-3A, the first successful large-scale human trial of a fungal vaccine; the standardization of the A/J mouse model for C. auris; the emergence of multi-epitope computational platforms with >94% HLA population coverage; and cross-kingdom protection paradigms. Major obstacles included commensal-to-pathogen duality of Candida, immunocompromised host paradox, antigenic plasticity, and chronic underinvestment. Converging next-generation vaccine strategies are beginning to bridge the gap between bench discovery and clinical implementation.