Technologies to improve immunisation safety.

Ever since a vaccine was first used against smallpox, adverse events following immunisation have been reported. Adverse reactions may be caused by a fault in vaccine production, idiosyncratic responses or unsafe handling and vaccine administration practices. Technological advances that promise to bypass many of the dangers currently associated with vaccine administration are described. Plans for the next decade and beyond include developing injection-free systems for vaccine delivery that overcome the limitations of current immunisation programmes and help prevent programmatic mistakes. Also under development are new parenteral administration devices such as the auto-disable syringe and the mono-dose pre-filled device, and mucosal and transcutaneous immunisation systems. Training needs to be at the forefront of efforts to limit human error. Above all, there must be a willingness to respond to new climates and new technologies in order to ensure safe immunisation of children globally.