Such patients are therefore at an elevated risk Omipalisib ic50 of infection from pathogens such as herpesviruses (particularly CMV and Epstein–Barr virus), HBV, HCV, pneumocystis and coinfections and represent a special population regarding immunisation. Despite a likely reduction in the efficacy of vaccinations in immunocompromised individuals, immunisation remains a frequent recommendation in the hope that at

least partial immunity will be achieved. Eliciting a response from vaccination in immunocompromised patients may require an increase in the dose and/or number of doses; altering the dosing interval; selecting a different vaccine formulation; or administration via an alternative route. Evidence in this patient population is lacking and guidelines are often based on theoretical assumptions. Live vaccines are generally contraindicated in immunocompromised or immunosuppressed individuals due to the risk of an active and symptomatic infection resulting from the vaccine itself (non-controlled replication process). Encouragingly, vaccine formulations with highly purified antigens

selleck chemical and novel adjuvants or alternative deliveries have been shown to induce more effective immune responses than the classical inactivated vaccines in immunocompromised hosts, including patients with end-stage renal diseases in pre-haemodialysis and haemodialysis (see Chapter 4 – Vaccine Adjuvants), patients with HIV and those who have received haematological stem cell transplants. The future of vaccine development can build on the knowledge and experience gained over the last 200 years, and at the same time can take advantage of the most cutting-edge technologies and research. New approaches to antigen selection and production, antigen

delivery, adjuvantation and vaccine administration will allow us to target established and emerging diseases, and populations with complex needs. Vaccination has been one of the most successful and cost-effective health interventions ever conceived and is now expanding further into cancer and chronic diseases. This expansion of scope and the subsequent impact on human 4��8C disease is likely to continue into the future in currently unforeseen ways, further increasing the importance of vaccine science and engineering in improving human health. “
“Supplementary Table 1. Pathogen-associated molecular patterns and their innate receptors “
“Words and phrases within the text that are defined in the glossary are given in italics. Adaptive immune system the antigen-specific line of defence, which is activated and expanded in response to chemical and molecular signals from the innate immune system. These signals are delivered via antigen-presenting cells (APCs). The type of signals received and the resulting cytokine response determine the nature of adaptive response.