Journal of Vaccine Research 2024, Vol.14, No.5, 217-230 http://medscipublisher.com/index.php/jvr 217 Systematic Review Open Access Safety and Efficacy of Multi-Pathogen Vaccines: A Comprehensive Review YongZhang Beijing Sino Biopharmaceutical Co., Ltd., Chaoyang, 100020, Beijing, China Corresponding email: zhangyong@foxmail.com Journal of Vaccine Research, 2024, Vol.14, No.5 doi: 10.5376/jvr.2024.14.0021 Received: 15 Jul., 2024 Accepted: 31 Aug., 2024 Published: 07 Sep., 2024 Copyright © 2024 Zhang, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Zhang Y., 2024, Safety and efficacy of multi-pathogen vaccines: a comprehensive review, Journal of Vaccine Research, 14(5): 217-230 (doi: 10.5376/jvr.2024.14.0021) Abstract The development of multi-pathogen vaccines offers a promising approach to improving global immunization efforts by providing protection against multiple infectious pathogens with a single formulation. This study comprehensively evaluates the safety and efficacy of multi-pathogen vaccines, examining their historical development, biological and immunological foundations, and key case studies. While multi-pathogen vaccines have significant advantages in simplifying immunization schedules, reducing healthcare costs, and increasing vaccine coverage, they also face unique challenges such as immune interference, production complexity, and regulatory hurdles. This study discusses strategies to enhance the safety and efficacy of these vaccines, including the use of advanced adjuvants, optimized dosing regimens, novel delivery systems, and synergistic agents. The research provides valuable insights into the opportunities and challenges of multi-pathogen vaccines and emphasizes their potential role in addressing the global burden of infectious diseases. Keywords Multi-pathogen vaccines; Vaccine safety; Vaccine efficacy; Immune interference; mRNA technology 1 Introduction In recent years, the development of multi-pathogen vaccines has gained considerable attention due to their potential to provide protection against multiple infectious agents in a single formulation. These vaccines, designed to target more than one pathogen simultaneously, offer significant advantages in global health efforts, particularly in regions with limited healthcare access and high disease burdens (Sharma et al., 2021). Studies on vaccines such as the multi-dose PfSPZ Vaccine and other combined vaccines have shown promise in protecting against multiple diseases effectively (Voysey et al., 2020; Jongo et al., 2022). The convenience of a single-dose vaccine capable of immunizing against various diseases can lead to improved vaccination rates, reduced costs, and simplified immunization schedules. However, the safety and efficacy of multi-pathogen vaccines are critical concerns that must be thoroughly assessed to ensure their successful implementation. Vaccine safety refers to the ability to induce immunity without causing significant adverse effects, while efficacy ensures the vaccine’s capability to offer adequate protection against targeted diseases(Zhou et al., 2021; Xu et al., 2024). These factors are paramount for public acceptance and widespread use, making it essential to evaluate multi-pathogen vaccines rigorously (Folegatti et al., 2020). Trials of vaccines like the IC43 Pseudomonas aeruginosa vaccine and others demonstrate the importance of ensuring vaccines are both immunogenic and safe, even in high-risk populations (Adlbrecht et al., 2020; Logunov et al., 2021). This study will conduct a comprehensive analysis of the safety and efficacy of existing multi-pathogen vaccines. By reviewing current research and clinical trial data that demonstrate their effectiveness and safety, this study highlights the potential benefits and challenges of multi-pathogen vaccines. In the context of combating emerging infectious diseases and achieving broad-spectrum protection, the findings provide guidance for future vaccine development strategies. 2 Historical Overview of Multi-Pathogen Vaccine Development 2.1 Evolution of vaccine development The development of vaccines has undergone significant evolution since the first successful vaccine, which was the smallpox vaccine introduced by Edward Jenner in the late 18th century (Figure 1). Traditional vaccines were
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