[New vaccines. What can we expect in the coming years?]

There is an urgent need for new vaccines. The biotechnological revolution has created new hope. However, developments are hampered by inadequate basic knowledge about the immunology of infections, and lack of coordination between public and commercial research and development work on vaccines. Recombinant vaccines are an important step forward when combined with new adjuvants, but the authorization of these adjuvants for use in humans has been slow. Recombinant live vectors for vaccine antigens circumvent this problem, but imply some risk in HIV-infected people. Nucleic acid vaccines are met with strong emotional resistance, because of many unanswered questions as to their safety. Mucosal vaccines make quality control simpler, open up for a safer use of live recombinant vectors and simplify delivery of the vaccine. New vaccines marketed in the last decade are surprisingly "old-fashioned". Traditional ways of making vaccines have still not been abandoned.