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July 28, 1999

Herpes Simplex Virus Vaccines— Why Don't Antibodies Protect?

Author Affiliations

Author Affiliation: Division of Retrovirology, Walter Reed Army Institute of Research, Rockville, Md.

JAMA. 1999;282(4):379-380. doi:10.1001/jama.282.4.379

Most effective viral vaccines work, at least in part, by inducing antibodies capable of neutralizing the invading virus.1-3 Examples among licensed human vaccines include measles, polio, rabies, influenza, hepatitis A, and hepatitis B vaccines.4-6 Even for diseases such as chickenpox, in which cellular immunity is thought to control disease, administration of specific antibody (eg, varicella-zoster immune globulin) can protect against disease when administered up to 96 hours following viral exposure.7 Therefore, the report by Corey and colleagues in this issue of THE JOURNAL8 is perhaps surprising because a herpes simplex virus type 2 (HSV-2) vaccine that induced high levels of neutralizing antibodies did not protect against HSV-2 infection. The possible reasons for the apparent failure of this vaccine highlight the empirical nature of vaccine science, the limitations of preclinical and animal model studies, and the need for well-designed human efficacy trials.

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