Vaccines against
infectious diseases have been available since the 1800s, when an immunization strategy against
smallpox developed by Jenner gained wide acceptance. Until recently, the only vaccination strategies available involved the use of
protein-based, whole killed, and attenuated live virus
vaccines. These strategies have led to the development of effective
vaccines against a variety of diseases with primary or prominent cutaneous manifestations. Effective and safe
vaccines now used worldwide include those directed against
measles and
rubella (now commonly used together with a
mumps vaccine as the trivalent MMR),
chickenpox, and
hepatitis B. The eradication of naturally occurring
smallpox remains one of the greatest successes in the history of modern medicine, but stockpiles of live
smallpox exist in the United States and Russia. Renewed interest in the
smallpox vaccine reflects concerns about a possible bioterrorist threat using this virus.
Yellow fever is a hemorrhagic virus endemic to tropical areas of South America and Africa. An effective
vaccine for this virus has existed since 1937, and it is used widely in endemic areas of South America, and to a lesser extent in Africa. This
vaccine is recommended once every 10 years for people who are traveling to endemic areas. Advances in immunology have led to a greater understanding of immune system function in
viral diseases. Progress in genetics and molecular biology has allowed researchers to design
vaccines with novel mechanisms of action (eg,
DNA, vector, and VLP
vaccines).
Vaccines have also been designed to specifically target particular viral components, allowing for stimulation of various arms of the immune system as desired. Ongoing research shows promise in prophylactic and therapeutic vaccination for
viral infections with cutaneous manifestations. Further studies are necessary before
vaccines for HSV, HPV, and HIV become commercially available.