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Communicating effectively about the science of vaccination to a sceptical public is a challenge for all those engaged in vaccine immunobiology but is urgently needed to realign the dialogue and ensure public health 8. We also provide some perspectives on current and future challenges in continuing to protect the world’s population from common pathogens and emerging infectious threats. In this Review, which is primarily aimed at a broad scientific audience, we provide a guide to the history (Box 1), development, immunological basis and remarkable impact of vaccines and immunization programmes on infectious diseases to provide insight into the key issues facing immunologists today.
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There is a great need today for improved understanding of the immunological basis for vaccination to develop vaccines for hard-to-target pathogens (such as Mycobacterium tuberculosis, the bacterium that causes tuberculosis (TB)) 3 and antigenically variable pathogens (such as HIV) 4, to control outbreaks that threaten global health security (such as COVID-19 or Ebola) 5, 6 and to work out how to revive immune responses in the ageing immune system 7 to protect the growing population of older adults from infectious diseases. However, for much of history, vaccines have been developed through empirical research without the involvement of immunologists. Vaccines exploit the extraordinary ability of the highly evolved human immune system to respond to, and remember, encounters with pathogen antigens. This Review provides an introductory overview of vaccines, immunization and related issues and thereby aims to inform a broad scientific audience about the underlying immunological concepts. Moreover, recognition of the huge potential and challenges for vaccines to control disease outbreaks and protect the older population, together with the availability of an array of new technologies, make it the perfect time for immunologists to be involved in designing the next generation of powerful immunogens. Although it could be argued that immunology has not thus far contributed much to vaccine development, in that most of the vaccines we use today were developed and tested empirically, it is clear that there are major challenges ahead to develop new vaccines for difficult-to-target pathogens, for which we urgently need a better understanding of protective immunity. Immunization is a cornerstone of public health policy and is demonstrably highly cost-effective when used to protect child health.