[Developments in vaccines for prophylactic use (author's transl)].

The epidemiologic background on which the efficacy of vaccines has to be considered shows that the mortality of infectious diseases in the first seventy years of our century was reduced to an extent which goes far beyond all other diseases. This trend is similar in all countries of comparable status of zivilization. Trends in morbidity may be different, but no sufficient documentation is available for morbidity of infectious diseases in this country. Developments of new vaccines for industrialized countries will show a change compared with the present vaccines. After introduction of vaccines against the big killers until 1950 disabling diseases were the more recent target of immunoprophylaxis such as poliomyelitis, measles, rubella, mumps. Vaccine efficiency was greatly increased by vaccination campaigns for which strategies and tactics were developed in an almost military fashion. Analysis of the future vaccines reveals a further change not only by additional antigens but by new target groups of the population to be protected. Not only will more vaccines be developed for adults but also for certain risk groups. More knowledge of immune-defence mechanisms in such groups will be needed for the final success of such vaccines. Moreover immunoprophylaxis may even enable immunotherapy in future. The most dramatic effect of immunoprophylaxis is to be expected in the coming decades in the non-industrialized world. This will be effectuated not by the newer vaccines, but by products which we know already. It is the decision of WHO to include an "Expanded program of vaccination" into their help for developing countries. Here new technologies are under investigation which will procure a new round in vaccination tactics. Vaccination is planned by WHO not only to help to develop countries but to play a decisive role in the problem of over-population. Such expectations are based on the fact that in the industrialized world the birthrate fell while the infant survival rates rose. Vaccination then would be more than immunoprophylaxis; vaccination would have a place then among man's many intelligent answers to mankind's many natural problems.