A preventive vaccine is a substance introduced into the human body that teaches the immune system to detect and destroy a pathogen—which is a particular virus, bacterium or parasite that causes a preventable disease. All vaccines contain some harmless form or part of the pathogen they target. They exert their effects through the adaptive immune response, an arm of the immune system that learns to recognize and neutralize specific pathogens (as opposed to pathogens in general).
Vaccines can be made in a variety of ways, but only a handful of those approaches are applicable to the development of AIDS vaccines.
Types of vaccines:
- Whole-killed/Whole-inactivated vaccines: The active ingredient in these vaccines is an intact virus or bacterium that has been killed or otherwise stripped of its ability to infect humans. Examples include the cholera and injectable polio vaccines. This approach has not been applied to the development of vaccines against HIV, due to the small but inevitable risk that the viruses harvested for such preparations may not all have been killed or adequately inactivated.
- Live attenuated vaccines: Use a form of the targeted pathogen that is highly unlikely to be harmful—one capable, say, of multiplying, but not typically of causing disease. Examples include the measles vaccine and the oral vaccine against polio, which has been widely deployed in global efforts to eradicate the disease. Such vaccines can be very effective because they closely mimic the behavior of the targeted pathogen, giving the immune system a truer picture of what it would be up against. But due to the risk that attenuated HIV might revert to its disease-causing form, this approach has not been applied to the development of human AIDS vaccines.
- Subunit vaccines: Vaccines of this variety are composed of purified pieces of the pathogen—known as antigens—that generate a vigorous, protective immune response. Common subunit vaccines include the seasonal flu and hepatitis B vaccines. This approach was employed to devise the first AIDS vaccine candidate tested in humans, which failed to induce protection from HIV infection. AIDS researchers, including those affiliated with IAVI, are today revisiting this strategy in novel ways.
- DNA vaccine candidates: Such vaccine candidates are also designed to train the immune system to recognize a piece of the targeted bacterium or virus. The difference is that their active ingredients are not the purified antigens themselves, but circles of DNA, called plasmids, that carry genes encoding those antigens. Human cells passively take up these plasmids and produce the antigens that train the immune system to recognize the targeted pathogen. No vaccines of this sort have been approved for human use, but several AIDS vaccine development efforts have employed this approach.
- Recombinant vector vaccine candidates: These vaccine candidates, like DNA vaccine candidates, introduce genes for targeted antigens into the body. But the genes are inserted into a virus that actively infects human cells. The viruses chosen as vectors are safe to use because they do not ordinarily cause disease in humans and/or have been stripped of their ability to proliferate. No vaccines of this sort have been approved for human use, but several AIDS vaccine development efforts have employed this strategy.
