Most effective viral vaccines work, at least in part, by inducing antibodies
capable of neutralizing the invading virus.1- 3
Examples among licensed human vaccines include measles, polio, rabies, influenza,
hepatitis A, and hepatitis B vaccines.4- 6
Even for diseases such as chickenpox, in which cellular immunity is thought
to control disease, administration of specific antibody (eg, varicella-zoster
immune globulin) can protect against disease when administered up to 96 hours
following viral exposure.7 Therefore, the report
by Corey and colleagues in this issue of THE JOURNAL8
is perhaps surprising because a herpes simplex virus type 2 (HSV-2) vaccine
that induced high levels of neutralizing antibodies did not protect against
HSV-2 infection. The possible reasons for the apparent failure of this vaccine
highlight the empirical nature of vaccine science, the limitations of preclinical
and animal model studies, and the need for well-designed human efficacy trials.
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