Figure 2 Precision vaccines design. Overview of strategies to design precision vaccines which can effectively mimic immunity against pathogens as observed post natural infection. Natural infection often leads to immunological imprinting which provides long-term immunity and disease resistance to future exposure of pathogens. However, it can also lead to detrimental effects to the host as observed in disease outcomes. On the contrary, vaccination provides disease resistance but may be associated with waning immunity, insufficient protective immune response either in vulnerable populations or to prevent disease transmission, contraindications for immunocompromised hosts etc. Precision vaccines can guide the development of next generation vaccines by incorporating a toolkit for building vaccines to mimic natural immunity, which includes: i) immunogen design (such as antigens, small molecule TLR or other adjuvants, biological adjuvants such as cytokines); ii) optimizing formulations for targeted delivery to antigen presenting cells which can lead to subsequent long-lasting adaptive immune response (approaches such as hydrogels, cellular vehicles, nanocarriers and microparticles etc.); iii) optimizing delivery routes for enhancing immune response and mimicking the natural exposure to the pathogen (such as transdermal patch, injection site, sprayable gels for nasal routes) and iv) pre-clinical evaluation of vaccine formulations in appropriate animal models can be followed by clinical evaluation in distinct populations. System biology approaches from such clinical trials may be helpful to dissect age- and population specific vaccine-induced cellular and molecular signatures which correlate with protective immunity. Further, usage of human in vitro modelling may accelerate and/or expand hypothesis testing and selection of population specific adjuvants. These approaches can lead to precision vaccines tailored for long-term disease protection while abating disease outcomes associated with natural infection. Figure is created with BioRender.com.
Finally, further developments in vaccine delivery technologies could help in improving equitable vaccine coverage. A 100-year old technology for the administration of vaccines based on needle and syringe is still in use today. This technology is relatively complex to use, requires substantial training, is prone to programmatic errors, results in sharps waste, and may be a factor in the decreasing acceptability of vaccination [39]. New technologies, e.g., micro-array vaccine skin patches could allow less well-trained health workers to administer parenteral vaccines, reduce fear and hesitancy, simplify vaccine storage and transport, and improve vaccination coverage and reach [40].
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