Development of vaccines against common colds.

Respiratory tract viruses are particularly significant causes of illness and death in children and in the elderly. Vaccines offer the possibility of decreasing the severity and complications of viral respiratory disease, but development has been delayed by numerous factors. First, there are more than 200 serologically distinct RNA and DNA virus species and strains which cause an essentially similar spectrum of disease. Some re-infect at high efficiency despite little antigenic variation, while others exhibit extensive coat protein variability. Vaccine candidates show variable efficacy in partially immune adults, the immunocompromised and the elderly, and may be ineffective or pathogenic in neonates or in the presence of maternal antibodies. However, effective childhood vaccines are essential to prevent severe disease due to respiratory syncytial virus (RSV) and parainfluenza and to reduce virus transmission to adults. A number of promising vaccines are in clinical trial, and it is likely that vaccines against RSV and parainfluenza will be licensed within the next 5-10 years. Mucosal delivery and the use of novel adjuvants offers the prospect of better vaccines against influenza. The ultimate goal is to develop multivalent mucosal vaccines offering protection against a spectrum of respiratory infections.