Breakthrough vaccination

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A Impfdurchbruch (English. English vaccine breakthrough infection ) refers to the ineffectiveness of vaccines when the corresponding pathogen mutates , so it is no longer that the immune system is recognized. This leads to illness despite a previous vaccination or an infection .

principle

By escape mutations to pathogens change in the course of immune evasion . This may also affect the epitopes that were previously recognized as part of the immune response . As a result, the pathogen can reproduce less hindered or be reproduced for about two to five days until the immune system has adjusted to the changed epitopes.

Examples

In the case of the hepatitis B virus , mutations in HBsAg have been described that lead to a vaccination breakthrough. In the case of influenza virus A , the mutation rate is so high that neutralizing antibodies mainly act against one strain each time, and the composition of the influenza vaccines is therefore adjusted annually to the circulating variants of the previous year. Vaccine breakthroughs due to the high mutation rate are - along with virus latency - one of the challenges in the development of an HIV vaccine .

Individual evidence

  1. ^ H. Blaha: Infectious and tropical diseases, vaccinations. Springer-Verlag, 2013, ISBN 978-3-642-96426-8 , p. 149.
  2. ↑ WH Gerlich: Breakthrough of hepatitis B virus escape mutants after vaccination and virus reactivation. J. Clin. Virol. (2006) 36 (Suppl. 1): pp. 18-22 PMID 16831688 .
  3. ↑ K. Tajiri, Y. Shimizu: Unsolved problems and future perspectives of hepatitis B virus vaccination. In: World journal of gastroenterology. Volume 21, number 23, June 2015, pp. 7074–7083, doi : 10.3748 / wjg.v21.i23.7074 , PMID 26109794 , PMC 4476869 (free full text).
  4. ↑ J. Wrammert, K. Smith, J. Miller, WA Langley, K. Kokko, C. Larsen, NY Zheng, I. Mays, L. Garman, C. Helms, J. James, GM Air, JD Capra, R Ahmed, PC Wilson: Rapid cloning of high-affinity human monoclonal antibodies against influenza virus. In: Nature . Volume 453, number 7195, May 2008, pp. 667-671, doi : 10.1038 / nature06890 , PMID 18449194 , PMC 2515609 (free full text).
  5. ↑ JK Mann, T. Ndung'u: HIV-1 vaccine immunogen design strategies. In: Virology journal. Volume 12, 2015, p. 3, doi : 10.1186 / s12985-014-0221-0 , PMID 25616599 , PMC 4318220 (free full text).