New vector and vaccine platforms: mRNA, DNA, viral vectors.

PURPOSE OF REVIEW: The purpose of this review is to share the excitement of new developments in the field of vaccine vector modalities against infectious diseases. The focus is on HIV-1/AIDS with reference to the most successful as well as currently tested COVID-19 vaccines, and human trials, which best inform iterative vaccine improvements.

RECENT FINDINGS: Several genetic subunit vaccines against SARS-CoV-2 demonstrated protection against severe disease, obtained Emergency Use Authorization and scaled their production to billions of doses. Many more are in efficacy evaluation. In contrast, development of HIV-1 vaccines has been extremely difficult. Perseverance of scientists is deepening our understanding of what constitutes immunity against HIV-1 infection and how to achieve protective levels of relevant responses by active immunization, passive administration or a combination of both. Novel platforms led by RNA play a pivotal role. However, a difficult virus may require a complex approach. Proof of concept for HIV-1 prevention and cure might be at reach, and when it arrives, it will be a great and needed encouragement to the field.

SUMMARY: Despite the enormous success of drug treatment, vaccines remain the best solution and likely a necessary component of any package that truly ends the AIDS epidemic.