Rino Rappuoli, GSK Vaccines, Siena, Italy

Opportunities and challenges for vaccines
Vaccination has been the most effective medical intervention in the history of mankind. Infectious diseases that used to kill or cause disability in millions of people annually such as diphtheria, tetanus, smallpox, polio, measles, mumps, and rubella were conquered during the last century with the first wave of vaccines. The second wave of vaccination started during the 1980s and consisted of vaccines that were made possible by the new technologies such as recombinant DNA, conjugation, genomics, that allowed the development of vaccines against Hepatitis B, papillomavirus, Haemophilus influenzae, pneumococcus, and meningococcus. Thanks to the advances in understanding of the structure of the antigens and their epitopes and how they interact with the human immune system we are now entering the third wave of vaccine development, characterized by optimal design antigens, adjuvants and delivery systems. This new phase is expected to tackle disease such as tuberculosis, malaria, and HIV that have, so far, been refractory to vaccine development, to boost the field of therapeutic vaccination and to optimize the response against infectious disease that are not yet controlled by vaccination such as influenza and respiratory syncytial virus.