The strategic use of novel smallpox vaccines in the post-eradication world

Abstract

We still face a threat of orthopoxviruses in the form of biological weapons and emerging zoonoses. Therefore, there is a need to maintain a comprehensive defense strategy to counter the low-probability, high-impact threat of smallpox, as well as the ongoing threat of naturally occurring orthopoxvirus disease. The currently licensed live-virus smallpox vaccine ACAM2000 is effective, but associated with serious and even life-threatening adverse events. The health threat posed by this vaccine, and other previously licensed vaccines, has prevented many first responders, and even many in the military, from receiving a vaccine against smallpox. At the same time, global immunity produced during the smallpox eradication campaign is waning. Here, we review novel subunit/component vaccines and how they might play roles in unconventional strategies to defend against emerging orthopoxvirus diseases throughout the world and against smallpox used as a weapon of mass destruction.

Keywords::

• biological warfare
• disease eradication
• DNA vaccines
• humoral immunity
• orthopoxvirus
• subunit vaccines
• vaccination
• variola virus
• viral vectors
• zoonoses

Disclaimer

Opinions, interpretations, conclusions and recommendations are those of the author and not necessarily endorsed by the US Army or the Department of Defense.

Financial & competing interests disclosure

The authors are co-inventors on smallpox vaccine-related patents, issued and pending. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.