Monday, March 29, 2010

Vaccination - Current Situation and Perspective

In the last 200 years, since the time of Edward Jenner, vaccination has controlled many major diseases namely, small pox, diphtheria, tetanus, yellow fever, pertussis, hepatitis B, haemophilus influenza type B, poliomyelitis, measles, mumps, rubella. Vaccination has eradicated smallpox and many countries including Malaysia has been certified poliofree by WHO.

The impact of vaccination on the health of the global population is well known and well documented. With the exception of safe water, no other modality, not even antibiotics has had a major impact on mortality reduction and population growth. Vaccines remain undoubtedly one of the most effective and safest of health interventions. Nevertheless, immunization services face many challenges. Immunization safety - ensuring and monitoring the safety of all aspects of immunization, including vaccine quality, storage and handling, vaccine administration and disposal of sharps is one such challenge. Other issues include the concern about excessive mercury exposure to infants who received multiple thimerosal containing vaccines, vaccine shortages due to converging factors such as phasing out of the production of traditional less expensive vaccines used in developing countries by vaccines manufacturers in favor of more expensive combination vaccines.

Even though conventional vaccines constitute the greatest achievement of modern medicine, successful vaccines have yet to be introduced for many deadly and debilitating diseases such as malaria, AIDS, dengue and hepatitis C. This gap exists because standard immunization methods work poorly or pose unacceptable risks when targeted against certain illnesses. An alternative strategy involving the deliberate introduction of a DNA plasmid carrying an antigen coding gene that transfect cells in vivo and results in an immune response DNA vaccines. DNA vaccines or DNA based immunization has been called "the third vaccine revolution' and if used for human vaccination will have distinct advantages over traditional vaccines in cost and ease of production, delivery and since almost all plasmids can be manufactures in essentially the same way, substantial economies of scale can be achieved.

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