Personalized vaccinology: A review

Abstract

At the current time, the field of vaccinology remains empirical in many respects. Vaccine development, vaccine immunogenicity, and vaccine efficacy have, for the most part, historically been driven by an empiric "isolate-inactivate-inject" paradigm. In turn, a population-level public health paradigm of "the same dose for everyone for every disease" model has been the normative thinking in regard to prevention of vaccine-preventable infectious diseases. In addition, up until recently, no vaccines had been designed specifically to overcome the immunosenescence of aging, consistent with a post-WWII mentality of developing vaccines and vaccine programs for children. It is now recognized that the current lack of knowledge concerning how immune responses to vaccines are generated is a critical barrier to understanding poor vaccine responses in the elderly and in immunoimmaturity, discovery of new correlates of vaccine immunogenicity (vaccine response biomarkers), and a directed approach to new vaccine development. The new fields of vaccinomics and adversomics provide models that permit global profiling of the innate, humoral, and cellular immune responses integrated at a systems biology level. This has advanced the science beyond that of reductionist scientific approaches by revealing novel interactions between and within the immune system and other biological systems (beyond transcriptional level), which are critical to developing "downstream" adaptive humoral and cellular responses to infectious pathogens and vaccines. Others have applied systems level approaches to the study of antibody responses (a.k.a. "systems serology"), [1] high-dimensional cell subset immunophenotyping through CyTOF, [2,3] and vaccine induced metabolic changes [4]. In turn, this knowledge is being utilized to better understand the following: identifying who is at risk for which infections; the level of risk that exists regarding poor immunogenicity and/or serious adverse events; and the type or dose of vaccine needed to fully protect an individual. In toto, such approaches allow for a personalized approach to the practice of vaccinology, analogous to the substantial inroads that individualized medicine is playing in other fields of human health and medicine. Herein we briefly review the field of vaccinomics, adversomics, and personalized vaccinology.

Tuberculosis vaccines: Opportunities and challenges

“…For example, live vaccines or those delivered using viral vectors may induce CD8 T cell responses as well as CD4 T cells, and assays to detect these responses must be used. Vaccines for different age groups and perhaps even different setting may also need to be ‘personalized’, with associated fine tuning of any protective biomarker assays.…”

Mapping Host-Related Correlates of Influenza Vaccine-Induced Immune Response: An Umbrella Review of the Available Systematic Reviews and Meta-Analyses

“…This means that further studies are needed in order to upgrade the overall CES grading system. Furthermore, nowadays the field of vaccinology is still empirical in several aspects [83]. The current limited knowledge into qualitative and quantitative paradigms of the immune response generated by vaccines is a serious barrier to understanding poor vaccine immunogenicity in a plethora of physiological and pathological conditions.…”

“…The current limited knowledge into qualitative and quantitative paradigms of the immune response generated by vaccines is a serious barrier to understanding poor vaccine immunogenicity in a plethora of physiological and pathological conditions. Today, emerging scientific lines propose a personalized approach to the practice of vaccinology, as it happens for other healthcare fields [83,84]. Studying the host-related correlates of influenza vaccine-induced immune response could contribute to the production of new personalized vaccines and to the development of new patient-oriented vaccination strategies in a value-based public health perspective.…”

Personalized Human Papillomavirus Vaccination for Persistence of Immunity for Cervical Cancer Prevention: A Critical Review With Experts' Opinions

“…The population-level public health paradigm of "one size fits all" has been the norm in vaccine-preventable diseases (6). Introduction of childhood immunization with human papillomavirus (HPV) vaccine has resulted in apparent decrease of abnormal cervical lesions and HPV infection incidence in adulthood in some populations (7).…”

“…On the other hand, immunogenetic and immunogenomic variations in host immune response genes are involved in directing CD4+T cell responses for a long-term HPV immunity. Variants encoding Tolllike receptors, human leukocyte antigen (HLA) molecules, cytokines, and cytokine receptors, have been associated with heterogeneity of immune responses to a wide range of vaccines (6,14).…”