Recent advances in immunization.

Although the prevention of infection through immunization is a central goal of maternal-child health programs in all developing countries it is important to recognize that the role of vaccines varies greatly from country to country from infection to infection and from vaccine to vaccine. Immunization strategies must be as responsive to local disease patterns needs and opportunities as to technological advances in the creation production storage and delivery of vaccines. This paper outlines the present state of the art for vaccines against measles pertussis poliomyelitis tetanus and tuberculosis. Other childhood infections in the tropics in need of a vaccine are the enteric infections serious bacterial infections vertically transmitted viral infections and parasitic infections such as malaria. Immunization technologies related to the cold chain delivery techniques and adjuvants are constantly improving. Gains have also been made in outcome evaluation and disease surveillance. Ultimately the success of the immunization effort depends on community participation and awareness.