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Attenuated vaccine - Wikipedia

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class="vector-toc-list"> </ul> </li> <li id="toc-Mechanism" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Mechanism"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Mechanism</span> </div> </a> <ul id="toc-Mechanism-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Safety" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Safety"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Safety</span> </div> </a> <ul id="toc-Safety-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li 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class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Disadvantages"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2</span> <span>Disadvantages</span> </div> </a> <ul id="toc-Disadvantages-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-List_of_attenuated_vaccines" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#List_of_attenuated_vaccines"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>List of attenuated vaccines</span> </div> </a> <button aria-controls="toc-List_of_attenuated_vaccines-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle List of attenuated vaccines subsection</span> </button> <ul id="toc-List_of_attenuated_vaccines-sublist" class="vector-toc-list"> <li id="toc-Currently_in-use" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Currently_in-use"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1</span> <span>Currently in-use</span> </div> </a> <ul id="toc-Currently_in-use-sublist" class="vector-toc-list"> <li id="toc-Bacterial_vaccines" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Bacterial_vaccines"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1.1</span> <span>Bacterial vaccines</span> </div> </a> <ul id="toc-Bacterial_vaccines-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Viral_vaccines" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Viral_vaccines"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1.2</span> <span>Viral vaccines</span> </div> </a> <ul id="toc-Viral_vaccines-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-In_development" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#In_development"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.2</span> <span>In development</span> </div> </a> <ul id="toc-In_development-sublist" class="vector-toc-list"> <li id="toc-Bacterial_vaccines_2" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Bacterial_vaccines_2"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.2.1</span> <span>Bacterial vaccines</span> </div> </a> <ul id="toc-Bacterial_vaccines_2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Viral_vaccines_2" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Viral_vaccines_2"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.2.2</span> <span>Viral vaccines</span> </div> </a> <ul id="toc-Viral_vaccines_2-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" 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Available in 22 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-22" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">22 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%84%D9%82%D8%A7%D8%AD_%D9%85%D9%88%D9%87%D9%86" title="لقاح موهن – Arabic" lang="ar" hreflang="ar" data-title="لقاح موهن" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Vacuna_atenuada" title="Vacuna atenuada – Catalan" lang="ca" hreflang="ca" data-title="Vacuna atenuada" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Oslaben%C3%A1_vakc%C3%ADna" title="Oslabená vakcína – Czech" lang="cs" hreflang="cs" data-title="Oslabená vakcína" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Lebendimpfstoff" title="Lebendimpfstoff – German" lang="de" hreflang="de" data-title="Lebendimpfstoff" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Vacuna_atenuada" title="Vacuna atenuada – Spanish" lang="es" hreflang="es" data-title="Vacuna atenuada" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Txerto_moteldu" title="Txerto moteldu – Basque" lang="eu" hreflang="eu" data-title="Txerto moteldu" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%88%D8%A7%DA%A9%D8%B3%D9%86_%D8%B2%D9%86%D8%AF%D9%87" title="واکسن زنده – Persian" lang="fa" hreflang="fa" data-title="واکسن زنده" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Virus_att%C3%A9nu%C3%A9" title="Virus atténué – French" lang="fr" hreflang="fr" data-title="Virus atténué" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%95%BD%EB%8F%85%ED%99%94_%EB%B0%B1%EC%8B%A0" title="약독화 백신 – Korean" lang="ko" hreflang="ko" data-title="약독화 백신" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B9%D5%B8%D6%82%D5%AC%D5%A1%D6%81%D5%BE%D5%A1%D5%AE_%D5%BA%D5%A1%D5%BF%D5%BE%D5%A1%D5%BD%D5%BF%D5%A1%D5%B6%D5%B5%D5%B8%D6%82%D5%A9" title="Թուլացված պատվաստանյութ – Armenian" lang="hy" hreflang="hy" data-title="Թուլացված պատվաստանյութ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%97%D7%99%D7%A1%D7%95%D7%9F_%D7%9E%D7%95%D7%97%D7%9C%D7%A9" title="חיסון מוחלש – Hebrew" lang="he" hreflang="he" data-title="חיסון מוחלש" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%85%E0%B4%B1%E0%B5%8D%E0%B4%B1%E0%B5%86%E0%B4%A8%E0%B5%8D%E0%B4%B5%E0%B5%87%E0%B4%B1%E0%B5%8D%E0%B4%B1%E0%B4%A1%E0%B5%8D_%E0%B4%B5%E0%B4%BE%E0%B4%95%E0%B5%8D%E0%B4%B8%E0%B4%BF%E0%B5%BB" title="അറ്റെന്വേറ്റഡ് വാക്സിൻ – Malayalam" lang="ml" hreflang="ml" data-title="അറ്റെന്വേറ്റഡ് വാക്സിൻ" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Levend_vaccin" title="Levend vaccin – Dutch" lang="nl" hreflang="nl" data-title="Levend vaccin" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E7%94%9F%E3%83%AF%E3%82%AF%E3%83%81%E3%83%B3" title="生ワクチン – Japanese" lang="ja" hreflang="ja" data-title="生ワクチン" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Svekket_virus-vaksine" title="Svekket virus-vaksine – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Svekket virus-vaksine" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Atenuacja" title="Atenuacja – Polish" lang="pl" hreflang="pl" data-title="Atenuacja" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/V%C3%ADrus_atenuado" title="Vírus atenuado – Portuguese" lang="pt" hreflang="pt" data-title="Vírus atenuado" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%96%D0%B8%D0%B2%D0%B0_%D0%B2%D0%B0%D0%BA%D1%86%D0%B8%D0%BD%D0%B0" title="Жива вакцина – Serbian" lang="sr" hreflang="sr" data-title="Жива вакцина" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%A7%E0%B8%B1%E0%B8%84%E0%B8%8B%E0%B8%B5%E0%B8%99%E0%B9%80%E0%B8%8A%E0%B8%B7%E0%B9%89%E0%B8%AD%E0%B8%A5%E0%B8%94%E0%B8%A4%E0%B8%97%E0%B8%98%E0%B8%B4%E0%B9%8C" title="วัคซีนเชื้อลดฤทธิ์ – Thai" lang="th" hreflang="th" data-title="วัคซีนเชื้อลดฤทธิ์" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Zay%C4%B1flat%C4%B1lm%C4%B1%C5%9F_a%C5%9F%C4%B1" title="Zayıflatılmış aşı – Turkish" lang="tr" hreflang="tr" data-title="Zayıflatılmış aşı" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/V%E1%BA%AFc-xin_s%E1%BB%91ng" title="Vắc-xin sống – Vietnamese" lang="vi" hreflang="vi" data-title="Vắc-xin sống" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E6%B8%9B%E6%AF%92%E7%96%AB%E8%8B%97" title="減毒疫苗 – Chinese" lang="zh" hreflang="zh" data-title="減毒疫苗" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q1810913#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div 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dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Vaccine that uses a weakened form of the germ</div> <p> An <b>attenuated vaccine</b> (or a live attenuated vaccine, LAV) is a <a href="/wiki/Vaccine" title="Vaccine">vaccine</a> created by reducing the <a href="/wiki/Virulence" title="Virulence">virulence</a> of a <a href="/wiki/Pathogen" title="Pathogen">pathogen</a>, but still keeping it viable (or "live").<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> Attenuation takes an infectious agent and alters it so that it becomes harmless or less virulent.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> These vaccines contrast to those produced by "killing" the pathogen (<a href="/wiki/Inactivated_vaccine" title="Inactivated vaccine">inactivated vaccine</a>). </p><p>Attenuated vaccines stimulate a strong and effective immune response that is long-lasting.<sup id="cite_ref-:132_3-0" class="reference"><a href="#cite_note-:132-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> In comparison to inactivated vaccines, attenuated vaccines produce a stronger and more durable immune response with a quick immunity onset.<sup id="cite_ref-:52_4-0" class="reference"><a href="#cite_note-:52-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:62_5-0" class="reference"><a href="#cite_note-:62-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:72_6-0" class="reference"><a href="#cite_note-:72-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> They are generally avoided in pregnancy and in patients with severe immunodeficiencies.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> Attenuated vaccines function by encouraging the body to create <a href="/wiki/Antibody" title="Antibody">antibodies</a> and <a href="/wiki/Adaptive_immune_system" title="Adaptive immune system">memory immune cells</a> in response to the specific pathogen which the vaccine protects against.<sup id="cite_ref-:02_8-0" class="reference"><a href="#cite_note-:02-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> Common examples of live attenuated vaccines are <a href="/wiki/Measles_vaccine" title="Measles vaccine">measles</a>, <a href="/wiki/Mumps_vaccine" title="Mumps vaccine">mumps</a>, <a href="/wiki/Rubella_vaccine" title="Rubella vaccine">rubella</a>, <a href="/wiki/Yellow_fever_vaccine" title="Yellow fever vaccine">yellow fever</a>, and some <a href="/wiki/Influenza_vaccine" title="Influenza vaccine">influenza</a> vaccines.<sup id="cite_ref-:132_3-1" class="reference"><a href="#cite_note-:132-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Development">Development</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=1" title="Edit section: Development"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Attenuated_viruses">Attenuated viruses</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=2" title="Edit section: Attenuated viruses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Viruses may be attenuated using the principles of <a href="/wiki/Evolution" title="Evolution">evolution</a> with <a href="/wiki/Serial_passage" title="Serial passage">serial passage</a> of the virus through a foreign <a href="/wiki/Host_(biology)" title="Host (biology)">host</a> species, such as:<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:0_10-0" class="reference"><a href="#cite_note-:0-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> </p> <ul><li><a href="/wiki/Tissue_culture" title="Tissue culture">Tissue culture</a></li> <li>Embryonated <a href="/wiki/Egg_(biology)" class="mw-redirect" title="Egg (biology)">eggs</a> (often chicken)</li> <li>Live animals</li></ul> <p>The initial virus population is applied to a foreign host. Through natural <a href="/wiki/Genetic_variability" title="Genetic variability">genetic variability</a> or induced <a href="/wiki/Mutation" title="Mutation">mutation</a>, a small percentage of the viral particles should have the capacity to infect the new host.<sup id="cite_ref-:0_10-1" class="reference"><a href="#cite_note-:0-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:2_11-0" class="reference"><a href="#cite_note-:2-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> These strains will continue to evolve within the new host and the virus will gradually lose its efficacy in the original host, due to lack of <a href="/wiki/Selection_pressure" class="mw-redirect" title="Selection pressure">selection pressure</a>.<sup id="cite_ref-:0_10-2" class="reference"><a href="#cite_note-:0-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:2_11-1" class="reference"><a href="#cite_note-:2-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> This process is known as "passage" in which the virus becomes so well adapted to the foreign host that it is no longer harmful to the subject that is to receive the vaccine.<sup id="cite_ref-:2_11-2" class="reference"><a href="#cite_note-:2-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> This makes it easier for the host immune system to eliminate the agent and create the immunological memory cells which will likely protect the patient if they are infected with a similar version of the virus in "the wild".<sup id="cite_ref-:2_11-3" class="reference"><a href="#cite_note-:2-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> </p><p>Viruses may also be <a href="/wiki/Reverse_genetics#Vaccine_synthesis" title="Reverse genetics">attenuated via reverse genetics</a>.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup> Attenuation by genetics is also used in the production of <a href="/wiki/Oncolytic_virus" title="Oncolytic virus">oncolytic viruses</a>.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Attenuated_bacteria">Attenuated bacteria</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=3" title="Edit section: Attenuated bacteria"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Bacteria is typically attenuated by passage, similar to the method used in viruses.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">&#91;</span>14<span class="cite-bracket">&#93;</span></a></sup> Gene knockout guided by reverse genetics is also used.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Administration">Administration</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=4" title="Edit section: Administration"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Attenuated vaccines can be administered in a variety of ways: </p> <ul><li>Injections: <ul><li><a href="/wiki/Subcutaneous_administration" title="Subcutaneous administration">Subcutaneous</a> (e.g. <a href="/wiki/MMR_vaccine" title="MMR vaccine">measles, mumps and rubella vaccine</a>, <a href="/wiki/Varicella_vaccine" title="Varicella vaccine">varicella vaccine</a>, <a href="/wiki/Yellow_fever_vaccine" title="Yellow fever vaccine">yellow fever vaccine</a>)<sup id="cite_ref-:8_16-0" class="reference"><a href="#cite_note-:8-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Intradermal_injection" title="Intradermal injection">Intradermal</a> (e.g. <a href="/wiki/Tuberculosis_vaccines" title="Tuberculosis vaccines">tuberculosis vaccine</a>, <a href="/wiki/Smallpox_vaccine" title="Smallpox vaccine">smallpox vaccine</a>)<sup id="cite_ref-:8_16-1" class="reference"><a href="#cite_note-:8-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup></li></ul></li> <li>Mucosal: <ul><li>Nasal (e.g. <a href="/wiki/Live_attenuated_influenza_vaccine" title="Live attenuated influenza vaccine">live attenuated influenza vaccine</a>)<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:8_16-2" class="reference"><a href="#cite_note-:8-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup></li> <li>Oral (e.g. <a href="/wiki/Oral_polio_vaccine" class="mw-redirect" title="Oral polio vaccine">oral polio vaccine</a>, <a href="/wiki/Recombinant_DNA" title="Recombinant DNA">recombinant</a> live attenuated <a href="/wiki/Cholera_vaccine" title="Cholera vaccine">cholera vaccine</a>, <a href="/wiki/Typhoid_vaccine" title="Typhoid vaccine">oral typhoid vaccine</a>, <a href="/wiki/Rotavirus_vaccine" title="Rotavirus vaccine">oral rotavirus vaccine</a>)<sup id="cite_ref-:8_16-3" class="reference"><a href="#cite_note-:8-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:9_18-0" class="reference"><a href="#cite_note-:9-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup></li></ul></li></ul> <p>Oral vaccines or subcutaneous/intramuscular injection are for individuals older than 12 months. Live attenuated vaccines, with the exception of the rotavirus vaccine given at 6 weeks, is not indicated for infants younger than 9 months.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=5" title="Edit section: Mechanism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Vaccines function by encouraging the creation of immune cells, such as <a href="/wiki/Cytotoxic_T_cell" title="Cytotoxic T cell">CD8+</a> and <a href="/wiki/T_helper_cell" title="T helper cell">CD4+ T lymphocytes</a>, or molecules, such as <a href="/wiki/Antibody" title="Antibody">antibodies</a>, that are specific to the <a href="/wiki/Pathogen" title="Pathogen">pathogen</a>.<sup id="cite_ref-:02_8-1" class="reference"><a href="#cite_note-:02-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> The cells and molecules can either prevent or reduce infection by killing infected cells or by producing <a href="/wiki/Interleukin" title="Interleukin">interleukins</a>.<sup id="cite_ref-:02_8-2" class="reference"><a href="#cite_note-:02-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> The specific effectors evoked can be different based on the vaccine.<sup id="cite_ref-:02_8-3" class="reference"><a href="#cite_note-:02-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> Live attenuated vaccines tend to help with the production of CD8+ cytotoxic T lymphocytes and T-dependent antibody responses.<sup id="cite_ref-:02_8-4" class="reference"><a href="#cite_note-:02-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> A vaccine is only effective for as long as the body maintains a population of these cells.<sup id="cite_ref-:02_8-5" class="reference"><a href="#cite_note-:02-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> </p><p>Attenuated vaccines are “weakened” versions of pathogens (virus or bacteria). They are modified so that it cannot cause harm or disease in the body but are still able to activate the immune system.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup> This type of vaccine works by activating both the cellular and humoral immune responses of the adaptive immune system. When a person receives an oral or injection of the vaccine, B cells, which help make antibodies, are activated in two ways: T cell-dependent and T-cell independent activation.<sup id="cite_ref-:5_21-0" class="reference"><a href="#cite_note-:5-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> </p><p>In T-cell dependent activation of B cells, B cells first recognize and present the antigen on MHCII receptors. T-cells can then recognize this presentation and bind to the B cell, resulting in clonal proliferation. This also helps IgM and plasma cells production as well as immunoglobulin switching. On the other hand, T-cell independent activation of B cells is due to non-protein antigens. This can lead to production of IgM antibodies. Being able to produce a B-cell response as well as memory killer T cells is a key feature of attenuated virus vaccines that help induce a potent immunity.<sup id="cite_ref-:5_21-1" class="reference"><a href="#cite_note-:5-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Safety">Safety</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=6" title="Edit section: Safety"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Live-attenuated vaccines are safe and stimulate a strong and effective immune response that is long-lasting.<sup id="cite_ref-:132_3-2" class="reference"><a href="#cite_note-:132-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> Given pathogens are attenuated, it is extremely rare for pathogens to revert to their pathogenic form and subsequently cause disease.<sup id="cite_ref-:142_22-0" class="reference"><a href="#cite_note-:142-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> Additionally, within the five WHO-recommended live attenuated vaccines (tuberculosis, oral polio, measles, rotavirus, and yellow fever), severe adverse reactions are extremely rare.<sup id="cite_ref-:142_22-1" class="reference"><a href="#cite_note-:142-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> </p><p>Individuals with severely compromised immune systems (e.g., <a href="/wiki/HIV" title="HIV">HIV-infection</a>, <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, <a href="/wiki/Immunosuppression" title="Immunosuppression">immunosuppressive therapy</a>, <a href="/wiki/Lymphoma" title="Lymphoma">lymphoma</a>, <a href="/wiki/Leukemia" title="Leukemia">leukemia</a>, <a href="/wiki/Combined_immunodeficiencies" title="Combined immunodeficiencies">combined immunodeficiencies</a>) typically should not receive live-attenuated vaccines as they may not be able to produce an adequate and safe immune response.<sup id="cite_ref-:132_3-3" class="reference"><a href="#cite_note-:132-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:142_22-2" class="reference"><a href="#cite_note-:142-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:15_23-0" class="reference"><a href="#cite_note-:15-23"><span class="cite-bracket">&#91;</span>23<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:3_24-0" class="reference"><a href="#cite_note-:3-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> Household contacts of immunodeficient individuals are still able to receive most attenuated vaccines since there is no increased risk of infection transmission, with the exception being the oral polio vaccine.<sup id="cite_ref-:3_24-1" class="reference"><a href="#cite_note-:3-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> </p><p>As precaution, live-attenuated vaccines are not typically administered during <a href="/wiki/Immunization_during_pregnancy" title="Immunization during pregnancy">pregnancy</a>.<sup id="cite_ref-:142_22-3" class="reference"><a href="#cite_note-:142-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:04_25-0" class="reference"><a href="#cite_note-:04-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup> This is due to the risk of transmission of virus between mother and fetus.<sup id="cite_ref-:04_25-1" class="reference"><a href="#cite_note-:04-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup> In particular, the <a href="/wiki/Varicella_vaccine" title="Varicella vaccine">varicella</a> and <a href="/wiki/Yellow_fever_vaccine" title="Yellow fever vaccine">yellow fever vaccines</a> have been shown to have adverse effects on fetuses and nursing babies.<sup id="cite_ref-:04_25-2" class="reference"><a href="#cite_note-:04-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup> </p><p>Some live attenuated vaccines have additional common, mild adverse effects due to their administration route.<sup id="cite_ref-:04_25-3" class="reference"><a href="#cite_note-:04-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup> For example, the <a href="/wiki/Live_attenuated_influenza_vaccine" title="Live attenuated influenza vaccine">live attenuated influenza vaccine</a> is given nasally and is associated with nasal congestion.<sup id="cite_ref-:04_25-4" class="reference"><a href="#cite_note-:04-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup> </p><p>Compared to <a href="/wiki/Inactivated_vaccine" title="Inactivated vaccine">inactivated vaccines</a>, live-attenuated vaccines are more prone to immunization errors as they must be kept under strict conditions during the <a href="/wiki/Cold_chain" title="Cold chain">cold chain</a> and carefully prepared (e.g., during reconstitution).<sup id="cite_ref-:132_3-4" class="reference"><a href="#cite_note-:132-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:142_22-4" class="reference"><a href="#cite_note-:142-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:15_23-1" class="reference"><a href="#cite_note-:15-23"><span class="cite-bracket">&#91;</span>23<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=7" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The history of <a href="/wiki/Vaccine" title="Vaccine">vaccine</a> development started with the creation of the <a href="/wiki/Smallpox_vaccine" title="Smallpox vaccine">smallpox vaccine</a> by <a href="/wiki/Edward_Jenner" title="Edward Jenner">Edward Jenner</a> in the late 18th century.<sup id="cite_ref-:18_26-0" class="reference"><a href="#cite_note-:18-26"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup> Jenner discovered that inoculating a human with an animal <a href="/wiki/Poxviridae" title="Poxviridae">pox virus</a> would grant immunity against <a href="/wiki/Smallpox" title="Smallpox">smallpox</a>, a disease considered to be one of the most devastating in human history.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">&#91;</span>28<span class="cite-bracket">&#93;</span></a></sup> Although the original <a href="/wiki/Smallpox_vaccine" title="Smallpox vaccine">smallpox vaccine</a> is sometimes considered to be an attenuated vaccine due to its live nature, it was not strictly-speaking attenuated since it was not derived directly from smallpox. Instead, it was based on the related and milder <a href="/wiki/Cowpox" title="Cowpox">cowpox</a> disease.<sup id="cite_ref-:11_29-0" class="reference"><a href="#cite_note-:11-29"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">&#91;</span>30<span class="cite-bracket">&#93;</span></a></sup> The discovery that diseases could be artificially attenuated came in the late 19th century when <a href="/wiki/Louis_Pasteur" title="Louis Pasteur">Louis Pasteur</a> was able to derive an attenuated strain of <a href="/wiki/Chicken_cholera" class="mw-redirect" title="Chicken cholera">chicken cholera</a>.<sup id="cite_ref-:11_29-1" class="reference"><a href="#cite_note-:11-29"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup> Pasteur applied this knowledge to develop an attenuated <a href="/wiki/Anthrax_vaccines" class="mw-redirect" title="Anthrax vaccines">anthrax vaccine</a> and demonstrating its effectiveness in a public experiment.<sup id="cite_ref-:12_31-0" class="reference"><a href="#cite_note-:12-31"><span class="cite-bracket">&#91;</span>31<span class="cite-bracket">&#93;</span></a></sup> The first <a href="/wiki/Rabies_vaccine" title="Rabies vaccine">rabies vaccine</a> was subsequently produced by Pasteur and <a href="/wiki/Pierre_Paul_%C3%89mile_Roux" class="mw-redirect" title="Pierre Paul Émile Roux">Emile Roux</a> by growing the virus in rabbits and drying the affected nervous tissue.<sup id="cite_ref-:12_31-1" class="reference"><a href="#cite_note-:12-31"><span class="cite-bracket">&#91;</span>31<span class="cite-bracket">&#93;</span></a></sup> </p><p>The technique of cultivating a virus repeatedly in artificial media and isolating less <a href="/wiki/Virulence" title="Virulence">virulent</a> strains was pioneered in the early 20th century by <a href="/wiki/Albert_Calmette" title="Albert Calmette">Albert Calmette</a> and <a href="/wiki/Camille_Gu%C3%A9rin" title="Camille Guérin">Camille Guérin</a> who developed an attenuated <a href="/wiki/Tuberculosis_vaccines" title="Tuberculosis vaccines">tuberculosis vaccine</a> called the <a href="/wiki/BCG_vaccine" title="BCG vaccine">BCG vaccine</a>.<sup id="cite_ref-:18_26-1" class="reference"><a href="#cite_note-:18-26"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup> This technique was later used by several teams when developing the vaccine for <a href="/wiki/Yellow_fever_vaccine" title="Yellow fever vaccine">yellow fever</a>, first by Sellards and <a href="/wiki/Jean_Laigret" title="Jean Laigret">Laigret</a>, and then by <a href="/wiki/Max_Theiler" title="Max Theiler">Theiler</a> and Smith.<sup id="cite_ref-:18_26-2" class="reference"><a href="#cite_note-:18-26"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:11_29-2" class="reference"><a href="#cite_note-:11-29"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:19_32-0" class="reference"><a href="#cite_note-:19-32"><span class="cite-bracket">&#91;</span>32<span class="cite-bracket">&#93;</span></a></sup> The vaccine developed by Theiler and Smith proved to be hugely successful and helped establish recommended practices and regulations for many other vaccines. These include the growth of viruses in primary tissue culture (e.g., chick embryos), as opposed to animals, and the use of the seed stock system which uses the original attenuated viruses as opposed to derived viruses (done to reduce variance in vaccine development and decrease the chance of adverse effects).<sup id="cite_ref-:11_29-3" class="reference"><a href="#cite_note-:11-29"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:19_32-1" class="reference"><a href="#cite_note-:19-32"><span class="cite-bracket">&#91;</span>32<span class="cite-bracket">&#93;</span></a></sup> The middle of the 20th century saw the work of many prominent virologists including <a href="/wiki/Albert_Sabin" title="Albert Sabin">Sabin</a>, <a href="/wiki/Maurice_Hilleman" title="Maurice Hilleman">Hilleman</a>, and <a href="/wiki/John_Franklin_Enders" title="John Franklin Enders">Enders</a>, and the introduction of several successful attenuated vaccines, such as those against <a href="/wiki/Polio_vaccine" title="Polio vaccine">polio</a>, <a href="/wiki/Measles_vaccine" title="Measles vaccine">measles</a>, <a href="/wiki/Mumps_vaccine" title="Mumps vaccine">mumps</a>, and <a href="/wiki/Rubella_vaccine" title="Rubella vaccine">rubella</a>.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">&#91;</span>33<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">&#91;</span>36<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Advantages_and_disadvantages">Advantages and disadvantages</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=8" title="Edit section: Advantages and disadvantages"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Advantages">Advantages</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=9" title="Edit section: Advantages"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Accurately imitate natural infections.<sup id="cite_ref-:4_37-0" class="reference"><a href="#cite_note-:4-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:03_38-0" class="reference"><a href="#cite_note-:03-38"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup></li> <li>Are effective at evoking both strong <a href="/wiki/Antibody" title="Antibody">antibody</a> and <a href="/wiki/Cell-mediated_immunity" title="Cell-mediated immunity">cell-mediated</a> immune reactions.<sup id="cite_ref-:4_37-1" class="reference"><a href="#cite_note-:4-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:03_38-1" class="reference"><a href="#cite_note-:03-38"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:52_4-1" class="reference"><a href="#cite_note-:52-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup></li> <li>Can elicit long-lasting or life-long immunity.<sup id="cite_ref-:4_37-2" class="reference"><a href="#cite_note-:4-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:03_38-2" class="reference"><a href="#cite_note-:03-38"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:62_5-1" class="reference"><a href="#cite_note-:62-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup></li> <li>Often only one or two doses are required.<sup id="cite_ref-:4_37-3" class="reference"><a href="#cite_note-:4-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:03_38-3" class="reference"><a href="#cite_note-:03-38"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:72_6-1" class="reference"><a href="#cite_note-:72-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup></li> <li>Quick immunity onset.<sup id="cite_ref-:52_4-2" class="reference"><a href="#cite_note-:52-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:62_5-2" class="reference"><a href="#cite_note-:62-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:72_6-2" class="reference"><a href="#cite_note-:72-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup></li> <li>Cost-effective (compared to some other health interventions).<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">&#91;</span>39<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">&#91;</span>40<span class="cite-bracket">&#93;</span></a></sup></li> <li>Can have strong beneficial <a href="/wiki/Non-specific_effect_of_vaccines" title="Non-specific effect of vaccines">non-specific effects</a>.<sup id="cite_ref-Benn132_41-0" class="reference"><a href="#cite_note-Benn132-41"><span class="cite-bracket">&#91;</span>41<span class="cite-bracket">&#93;</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Disadvantages">Disadvantages</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=10" title="Edit section: Disadvantages"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>In rare cases, particularly when there is inadequate vaccination of the population, natural <a href="/wiki/Mutation" title="Mutation">mutations</a> during <a href="/wiki/Viral_replication" title="Viral replication">viral replication</a>, or interference by related viruses, can cause an attenuated virus to revert to its <a href="/wiki/Wild_type" title="Wild type">wild-type</a> form or mutate to a new <a href="/wiki/Strain_(biology)" title="Strain (biology)">strain</a>, potentially resulting in the new virus being infectious or pathogenic.<sup id="cite_ref-:4_37-4" class="reference"><a href="#cite_note-:4-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Shimizu_20042_42-0" class="reference"><a href="#cite_note-Shimizu_20042-42"><span class="cite-bracket">&#91;</span>42<span class="cite-bracket">&#93;</span></a></sup></li> <li>Often not recommended in pregnancy or for severely <a href="/wiki/Immunodeficiency" title="Immunodeficiency">immunocompromised</a> patients due to the risk of potential complications.<sup id="cite_ref-:4_37-5" class="reference"><a href="#cite_note-:4-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-MMWR20112_43-0" class="reference"><a href="#cite_note-MMWR20112-43"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">&#91;</span>44<span class="cite-bracket">&#93;</span></a></sup></li> <li>Live strains typically require advanced maintenance, such as refrigeration and fresh media, making transport to remote areas difficult and costly.<sup id="cite_ref-:4_37-6" class="reference"><a href="#cite_note-:4-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">&#91;</span>45<span class="cite-bracket">&#93;</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="List_of_attenuated_vaccines">List of attenuated vaccines</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=11" title="Edit section: List of attenuated vaccines"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Currently_in-use">Currently in-use</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=12" title="Edit section: Currently in-use"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>For many of the pathogens listed below there are many vaccines, the list below simply indicates that there are one (or more) attenuated vaccines for that particular pathogen, not that all vaccines for that pathogen are attenuated.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2023)">citation needed</span></a></i>&#93;</sup> </p> <div class="mw-heading mw-heading4"><h4 id="Bacterial_vaccines">Bacterial vaccines</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=13" title="Edit section: Bacterial vaccines"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Anthrax_vaccines" class="mw-redirect" title="Anthrax vaccines">Anthrax vaccine</a><sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">&#91;</span>46<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Cholera_vaccine" title="Cholera vaccine">Cholera vaccine</a><sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">&#91;</span>47<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Plague_vaccine" title="Plague vaccine">Plague vaccine</a><sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Salmonella" title="Salmonella">Salmonella</a> vaccine<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">&#91;</span>49<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Tuberculosis_vaccines" title="Tuberculosis vaccines">Tuberculosis vaccine</a><sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">&#91;</span>50<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Typhoid_vaccine" title="Typhoid vaccine">Typhoid vaccine</a><sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">&#91;</span>51<span class="cite-bracket">&#93;</span></a></sup></li></ul> <div class="mw-heading mw-heading4"><h4 id="Viral_vaccines">Viral vaccines</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=14" title="Edit section: Viral vaccines"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Live_attenuated_influenza_vaccine" title="Live attenuated influenza vaccine">Live attenuated influenza vaccine (LAIV)</a><sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">&#91;</span>52<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Japanese_encephalitis_vaccine" title="Japanese encephalitis vaccine">Japanese encephalitis vaccine</a><sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">&#91;</span>53<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Measles_vaccine" title="Measles vaccine">Measles vaccine</a><sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">&#91;</span>54<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Mumps_vaccine" title="Mumps vaccine">Mumps vaccine</a><sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/MR_vaccine" class="mw-redirect" title="MR vaccine">Measles and rubella (MR) vaccine</a><sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/MMR_vaccine" title="MMR vaccine">Measles, mumps, and rubella (MMR) vaccine</a><sup id="cite_ref-:1_57-0" class="reference"><a href="#cite_note-:1-57"><span class="cite-bracket">&#91;</span>57<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/MMRV_vaccine" title="MMRV vaccine">Measles, mumps, rubella and varicella (MMRV) vaccine</a><sup id="cite_ref-:1_57-1" class="reference"><a href="#cite_note-:1-57"><span class="cite-bracket">&#91;</span>57<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Polio_vaccine" title="Polio vaccine">Polio vaccine</a><sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">&#91;</span>58<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Rotavirus_vaccine" title="Rotavirus vaccine">Rotavirus vaccine</a><sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">&#91;</span>59<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Rubella_vaccine" title="Rubella vaccine">Rubella vaccine</a><sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">&#91;</span>60<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Smallpox_vaccine" title="Smallpox vaccine">Smallpox vaccine</a><sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">&#91;</span>61<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Varicella_vaccine" title="Varicella vaccine">Varicella vaccine</a><sup id="cite_ref-62" class="reference"><a href="#cite_note-62"><span class="cite-bracket">&#91;</span>62<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Yellow_fever_vaccine" title="Yellow fever vaccine">Yellow fever vaccine</a><sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">&#91;</span>63<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Zoster_vaccine" title="Zoster vaccine">Zoster/shingles vaccine</a><sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">&#91;</span>64<span class="cite-bracket">&#93;</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="In_development">In development</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=15" title="Edit section: In development"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Bacterial_vaccines_2">Bacterial vaccines</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=16" title="Edit section: Bacterial vaccines"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Enterotoxigenic_Escherichia_coli" title="Enterotoxigenic Escherichia coli">Enterotoxigenic Escherichia coli</a> vaccine<sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">&#91;</span>65<span class="cite-bracket">&#93;</span></a></sup></li></ul> <div class="mw-heading mw-heading4"><h4 id="Viral_vaccines_2">Viral vaccines</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=17" title="Edit section: Viral vaccines"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Tick-borne_encephalitis_vaccine" title="Tick-borne encephalitis vaccine">Tick-borne encephalitis vaccine</a><sup id="cite_ref-66" class="reference"><a href="#cite_note-66"><span class="cite-bracket">&#91;</span>66<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/COVID-19" title="COVID-19">COVID-19</a><sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">&#91;</span>67<span class="cite-bracket">&#93;</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Attenuated_vaccine&amp;action=edit&amp;section=18" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFBadgettAuerCarmichaelParrish2002" class="citation journal cs1">Badgett, Marty R.; Auer, Alexandra; Carmichael, Leland E.; Parrish, Colin R.; Bull, James J. (October 2002). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC136581">"Evolutionary Dynamics of Viral Attenuation"</a>. <i>Journal of Virology</i>. <b>76</b> (20): 10524–10529. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2FJVI.76.20.10524-10529.2002">10.1128/JVI.76.20.10524-10529.2002</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a>&#160;<a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0022-538X">0022-538X</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC136581">136581</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12239331">12239331</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Journal+of+Virology&amp;rft.atitle=Evolutionary+Dynamics+of+Viral+Attenuation&amp;rft.volume=76&amp;rft.issue=20&amp;rft.pages=10524-10529&amp;rft.date=2002-10&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC136581%23id-name%3DPMC&amp;rft.issn=0022-538X&amp;rft_id=info%3Apmid%2F12239331&amp;rft_id=info%3Adoi%2F10.1128%2FJVI.76.20.10524-10529.2002&amp;rft.aulast=Badgett&amp;rft.aufirst=Marty+R.&amp;rft.au=Auer%2C+Alexandra&amp;rft.au=Carmichael%2C+Leland+E.&amp;rft.au=Parrish%2C+Colin+R.&amp;rft.au=Bull%2C+James+J.&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC136581&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAttenuated+vaccine" class="Z3988"></span></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPulendranAhmed2011" class="citation journal cs1">Pulendran, Bali; Ahmed, Rafi (June 2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253344">"Immunological mechanisms of vaccination"</a>. <i>Nature Immunology</i>. <b>12</b> (6): 509–517. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fni.2039">10.1038/ni.2039</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a>&#160;<a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1529-2908">1529-2908</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253344">3253344</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21739679">21739679</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Nature+Immunology&amp;rft.atitle=Immunological+mechanisms+of+vaccination&amp;rft.volume=12&amp;rft.issue=6&amp;rft.pages=509-517&amp;rft.date=2011-06&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3253344%23id-name%3DPMC&amp;rft.issn=1529-2908&amp;rft_id=info%3Apmid%2F21739679&amp;rft_id=info%3Adoi%2F10.1038%2Fni.2039&amp;rft.aulast=Pulendran&amp;rft.aufirst=Bali&amp;rft.au=Ahmed%2C+Rafi&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3253344&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAttenuated+vaccine" class="Z3988"></span></span> </li> <li id="cite_note-:132-3"><span class="mw-cite-backlink">^ <a href="#cite_ref-:132_3-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:132_3-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:132_3-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:132_3-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-:132_3-4"><sup><i><b>e</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.vaccines.gov/basics/types">"Vaccine Types | Vaccines"</a>. <i>www.vaccines.gov</i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20190523191043/https://www.vaccines.gov/basics/types">Archived</a> from the original on 23 May 2019<span class="reference-accessdate">. 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class="external text" href="https://web.archive.org/web/20070604164605/http://www.polioeradication.org/vaccines.asp">Global Polio Eradication Initiative: Advantages and Disadvantages of Vaccine Types</a></li> <li><a rel="nofollow" class="external text" href="https://www.cdc.gov/h1n1flu/vaccination/nasalspray_qa.htm">CDC H1N1 Flu / 2009 H1N1 Nasal Spray Vaccine Q&amp;A</a> at the website of the US <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a></li></ul> <style data-mw-deduplicate="TemplateStyles:r1130092004">.mw-parser-output .portal-bar{font-size:88%;font-weight:bold;display:flex;justify-content:center;align-items:baseline}.mw-parser-output .portal-bar-bordered{padding:0 2em;background-color:#fdfdfd;border:1px solid #a2a9b1;clear:both;margin:1em auto 0}.mw-parser-output .portal-bar-related{font-size:100%;justify-content:flex-start}.mw-parser-output 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id="Artificial_induction_of_immunity_/_Immunization:_Vaccines,_Vaccination,_Infection,_Inoculation_(J07)" style="font-size:114%;margin:0 4em"><a href="/wiki/Artificial_induction_of_immunity" title="Artificial induction of immunity">Artificial induction of immunity</a> / <a href="/wiki/Immunization" title="Immunization">Immunization</a>: <a href="/wiki/Vaccine" title="Vaccine">Vaccines</a>, <a href="/wiki/Vaccination" title="Vaccination">Vaccination</a>, <a href="/wiki/Infection" title="Infection">Infection</a>, <a href="/wiki/Inoculation" title="Inoculation">Inoculation</a> (<a href="/wiki/ATC_code_J07" title="ATC code J07">J07</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Development</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Immunologic_adjuvant" title="Immunologic adjuvant">Adjuvants</a></li> <li><a href="/wiki/Vaccine_ingredients" title="Vaccine ingredients">Vaccine ingredients</a> <ul><li><a href="/wiki/List_of_vaccine_excipients" title="List of vaccine excipients">list</a></li></ul></li> <li><a href="/wiki/Mathematical_modelling_of_infectious_diseases" title="Mathematical modelling of infectious diseases">Mathematical modelling</a></li> <li><a href="/wiki/Vaccine_storage" title="Vaccine storage">Storage</a></li> <li><a href="/wiki/Timeline_of_human_vaccines" title="Timeline of human vaccines">Timeline</a></li> <li><a href="/wiki/Vaccine_trial" title="Vaccine trial">Trials</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Classes</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Conjugate_vaccine" title="Conjugate vaccine">Conjugate</a></li> <li><a href="/wiki/Inactivated_vaccine" title="Inactivated vaccine">Inactivated</a></li> <li>Live <ul><li><a class="mw-selflink selflink">Attenuated</a></li> <li><a href="/wiki/Heterologous_vaccine" title="Heterologous vaccine">Heterologous</a></li></ul></li> <li><a href="/wiki/Subunit_vaccine" title="Subunit vaccine">Subunit/component</a> / <a href="/wiki/Peptide_vaccine" title="Peptide vaccine">Peptide</a> / <a href="/wiki/Virus-like_particle" title="Virus-like particle">Virus-like particle</a> / <a href="/wiki/Synthetic_vaccine" title="Synthetic vaccine">Synthetic</a></li> <li><a href="/wiki/DNA_vaccine" title="DNA vaccine">DNA</a> / <a href="/wiki/MRNA_vaccine" title="MRNA vaccine">mRNA</a></li> <li><a href="/wiki/Therapeutic_vaccines" title="Therapeutic vaccines">Therapeutic</a></li> <li><a href="/wiki/Toxoid" title="Toxoid">Toxoid</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Administration</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Global: <ul><li><a href="/wiki/GAVI" title="GAVI">GAVI Alliance</a></li> <li><a href="/wiki/National_Immunization_Technical_Advisory_Group" title="National Immunization Technical Advisory Group">NITAG</a></li> <li><a href="/wiki/Strategic_Advisory_Group_of_Experts" title="Strategic Advisory Group of Experts">SAGE</a></li> <li><a href="/wiki/Vaccine_wastage" title="Vaccine wastage">Vaccine wastage</a></li> <li><a href="/wiki/Vaccination_policy" title="Vaccination policy">Policy</a></li> <li><a href="/wiki/Vaccination_schedule" title="Vaccination schedule">Schedule</a></li> <li><a href="/wiki/Vaccine_adverse_event" title="Vaccine adverse event">Vaccine injury</a></li></ul></li> <li>US: <ul><li><a href="/wiki/Advisory_Committee_on_Immunization_Practices" title="Advisory Committee on Immunization Practices">ACIP</a></li> <li><a href="/wiki/National_Vaccine_Injury_Compensation_Program" title="National Vaccine Injury Compensation Program">Vaccine court</a></li> <li><a href="/wiki/Vaccines_for_Children_Program" title="Vaccines for Children Program">Vaccines for Children Program</a></li> <li><a href="/wiki/Vaccine_Adverse_Event_Reporting_System" title="Vaccine Adverse Event Reporting System">VAERS</a></li> <li><a href="/wiki/Vaccine_Safety_Datalink" title="Vaccine Safety Datalink">VSD</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Vaccines</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Bacterial</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anthrax_vaccine" title="Anthrax vaccine">Anthrax</a></li> <li><a href="/wiki/Brucellosis_vaccine" title="Brucellosis vaccine">Brucellosis</a></li> <li><a href="/wiki/Cholera_vaccine" title="Cholera vaccine">Cholera</a><sup>#</sup></li> <li><a href="/wiki/Diphtheria_vaccine" title="Diphtheria vaccine">Diphtheria</a><sup>#</sup></li> <li><a href="/wiki/Hib_vaccine" title="Hib vaccine">Hib</a><sup>#</sup></li> <li><a href="/wiki/Leptospirosis#Prevention" title="Leptospirosis">Leptospirosis</a></li> <li><a href="/wiki/Lyme_disease#Vaccination" title="Lyme disease">Lyme disease</a><sup>‡</sup></li> <li><a href="/wiki/Meningococcal_vaccine" title="Meningococcal vaccine">Meningococcus</a><sup>#</sup> <ul><li><a href="/wiki/MeNZB" title="MeNZB">MeNZB</a></li> <li><a href="/wiki/NmVac4-A/C/Y/W-135" title="NmVac4-A/C/Y/W-135">NmVac4-A/C/Y/W-135</a></li></ul></li> <li><a href="/wiki/Pertussis_vaccine" title="Pertussis vaccine">Pertussis</a><sup>#</sup></li> <li><a href="/wiki/Plague_vaccine" title="Plague vaccine">Plague</a></li> <li><a href="/wiki/Pneumococcal_vaccine" title="Pneumococcal vaccine">Pneumococcal</a><sup>#</sup> <ul><li><a href="/wiki/Pneumococcal_conjugate_vaccine" title="Pneumococcal conjugate vaccine">PCV</a></li> <li><a href="/wiki/Pneumococcal_polysaccharide_vaccine" title="Pneumococcal polysaccharide vaccine">PPSV</a></li></ul></li> <li><a href="/wiki/Q_fever#Prevention" title="Q fever">Q fever</a></li> <li><a href="/wiki/Tetanus_vaccine" title="Tetanus vaccine">Tetanus</a><sup>#</sup></li> <li><a href="/wiki/Tuberculosis_vaccines" title="Tuberculosis vaccines">Tuberculosis</a> <ul><li><a href="/wiki/BCG_vaccine" title="BCG vaccine">BCG</a><sup>#</sup></li></ul></li> <li><a href="/wiki/Typhoid_vaccine" title="Typhoid vaccine">Typhoid</a><sup>#</sup> <ul><li><a href="/wiki/Ty21a" title="Ty21a">Ty21a</a></li> <li><a href="/wiki/Vi_capsular_polysaccharide_vaccine" title="Vi capsular polysaccharide vaccine">ViCPS</a></li></ul></li> <li><a href="/wiki/Typhus_vaccine" title="Typhus vaccine">Typhus</a></li> <li>combination: <ul><li><a href="/wiki/DPT_vaccine" title="DPT vaccine">DPT/DTwP/DTaP</a></li> <li><a href="/wiki/Tetanus_vaccine" title="Tetanus vaccine">Td/Tdap</a></li></ul></li> <li>research: <ul><li><a href="/wiki/Clostridioides_difficile_infection#Research" title="Clostridioides difficile infection">Clostridioides difficile</a></li> <li><a href="/wiki/Group_B_streptococcal_infection#Vaccine" title="Group B streptococcal infection">Group B streptococcal disease</a></li> <li><a href="/wiki/Shigellosis#Vaccine" title="Shigellosis">Shigellosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Viral</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adenovirus_vaccine" title="Adenovirus vaccine">Adenovirus</a></li> <li><a href="/wiki/Chikungunya_vaccine" title="Chikungunya vaccine">Chikungunya</a></li> <li><a href="/wiki/Ebola_vaccine" title="Ebola vaccine">Ebola</a> <ul><li><a href="/wiki/RVSV-ZEBOV_vaccine" title="RVSV-ZEBOV vaccine">rVSV-ZEBOV</a></li></ul></li> <li><a href="/wiki/Influenza_vaccine" title="Influenza vaccine">Flu</a><sup>#</sup> <ul><li><a href="/wiki/2009_swine_flu_pandemic_vaccine" title="2009 swine flu pandemic vaccine">H1N1</a> (<a href="/wiki/Pandemrix" title="Pandemrix">Pandemrix</a>)</li> <li><a href="/wiki/H5N1_vaccine" title="H5N1 vaccine">H5N1</a></li> <li><a href="/wiki/H5N8_vaccine" title="H5N8 vaccine">H5N8</a></li> <li><a href="/wiki/Live_attenuated_influenza_vaccine" title="Live attenuated influenza vaccine">LAIV</a></li></ul></li> <li><a href="/wiki/Hantavirus_vaccine" title="Hantavirus vaccine">Hantavirus</a></li> <li><a href="/wiki/Hepatitis_A_vaccine" title="Hepatitis A vaccine">Hepatitis A</a><sup>#</sup></li> <li><a href="/wiki/Hepatitis_B_vaccine" title="Hepatitis B vaccine">Hepatitis B</a><sup>#</sup></li> <li><a href="/wiki/Hepatitis_E#Vaccines" title="Hepatitis E">Hepatitis E</a></li> <li><a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV</a><sup>#</sup> <ul><li><a href="/wiki/Cervarix" title="Cervarix">Cervarix</a></li> <li><a href="/wiki/Gardasil" title="Gardasil">Gardasil</a></li></ul></li> <li><a href="/wiki/Japanese_encephalitis_vaccine" title="Japanese encephalitis vaccine">Japanese encephalitis</a><sup>#</sup></li> <li><a href="/wiki/Measles_vaccine" title="Measles vaccine">Measles</a><sup>#</sup></li> <li><a href="/wiki/Mpox_vaccine" class="mw-redirect" title="Mpox vaccine">Mpox</a></li> <li><a href="/wiki/Mumps_vaccine" title="Mumps vaccine">Mumps</a><sup>#</sup></li> <li><a href="/wiki/Polio_vaccine" title="Polio vaccine">Polio</a><sup>#</sup> <ul><li><a href="/wiki/Polio_vaccine#Attenuated" title="Polio vaccine">Sabin</a></li> <li><a href="/wiki/Polio_vaccine#Inactivated" title="Polio vaccine">Salk</a></li></ul></li> <li><a href="/wiki/Rabies_vaccine" title="Rabies vaccine">Rabies</a><sup>#</sup></li> <li><a href="/wiki/Rotavirus_vaccine" title="Rotavirus vaccine">Rotavirus</a><sup>#</sup></li> <li><a href="/wiki/Rubella_vaccine" title="Rubella vaccine">Rubella</a><sup>#</sup></li> <li><a href="/wiki/COVID-19_vaccine" title="COVID-19 vaccine">SARS-CoV-2</a> <ul><li><a href="/wiki/Corbevax" title="Corbevax">Corbevax</a><sup>†</sup></li> <li><a href="/wiki/Covaxin" title="Covaxin">Bharat Biotech</a><sup>†</sup></li> <li><a href="/wiki/Convidecia" title="Convidecia">CanSino</a><sup>†</sup></li> <li><a href="/wiki/CoronaVac" title="CoronaVac">CoronaVac</a><sup>†</sup></li> <li><a href="/wiki/EpiVacCorona" title="EpiVacCorona">EpiVacCorona</a><sup>†</sup></li> <li><a href="/wiki/Janssen_COVID-19_vaccine" title="Janssen COVID-19 vaccine">Janssen</a></li> <li><a href="/wiki/Moderna_COVID-19_vaccine" title="Moderna COVID-19 vaccine">Moderna</a></li> <li><a href="/wiki/Novavax_COVID-19_vaccine" title="Novavax COVID-19 vaccine">Novavax</a></li> <li><a href="/wiki/Oxford%E2%80%93AstraZeneca_COVID-19_vaccine" title="Oxford–AstraZeneca COVID-19 vaccine">Oxford–AstraZeneca</a></li> <li><a href="/wiki/Pfizer%E2%80%93BioNTech_COVID-19_vaccine" title="Pfizer–BioNTech COVID-19 vaccine">Pfizer–BioNTech</a></li> <li><a href="/wiki/Sanofi%E2%80%93GSK_COVID-19_vaccine" title="Sanofi–GSK COVID-19 vaccine">Sanofi–GSK</a><sup>†</sup></li> <li><a href="/wiki/Sinopharm_BIBP_COVID-19_vaccine" title="Sinopharm BIBP COVID-19 vaccine">Sinopharm BIBP</a><sup>†</sup></li> <li><a href="/wiki/Skycovione" title="Skycovione">Skycovione</a><sup>†</sup></li> <li><a href="/wiki/Sputnik_V_COVID-19_vaccine" title="Sputnik V COVID-19 vaccine">Sputnik V</a><sup>†</sup></li> <li><a href="/wiki/Valneva_COVID-19_vaccine" title="Valneva COVID-19 vaccine">Valneva</a><sup>†</sup></li></ul></li> <li><a href="/wiki/Respiratory_syncytial_virus_vaccine" title="Respiratory syncytial virus vaccine">Respiratory syncytial virus (RSV)</a></li> <li><a href="/wiki/Smallpox_vaccine" title="Smallpox vaccine">Smallpox</a></li> <li><a href="/wiki/Tick-borne_encephalitis_vaccine" title="Tick-borne encephalitis vaccine">Tick-borne encephalitis</a><sup>#</sup></li> <li>Varicella zoster <ul><li><a href="/wiki/Varicella_vaccine" title="Varicella vaccine">Chicken pox</a><sup>#</sup></li> <li><a href="/wiki/Zoster_vaccine" title="Zoster vaccine">Shingles</a></li></ul></li> <li><a href="/wiki/Yellow_fever_vaccine" title="Yellow fever vaccine">Yellow fever</a><sup>#</sup></li> <li>combination: <ul><li><a href="/wiki/Hepatitis_A_and_B_vaccine" title="Hepatitis A and B vaccine">Hepatitis A and B</a></li> <li><a href="/wiki/MMR_vaccine" title="MMR vaccine">MMR</a></li> <li><a href="/wiki/MMRV_vaccine" title="MMRV vaccine">MMRV</a></li></ul></li> <li>research: <ul><li><a href="/wiki/Cytomegalovirus_vaccine" title="Cytomegalovirus vaccine">Cytomegalovirus</a></li> <li><a href="/wiki/Dengue_vaccine" title="Dengue vaccine">Dengue</a><sup>#</sup></li> <li><a href="/wiki/Epstein%E2%80%93Barr_virus_vaccine" title="Epstein–Barr virus vaccine">Epstein–Barr virus</a></li> <li><a href="/wiki/Hepatitis_C_vaccine" title="Hepatitis C vaccine">Hepatitis C</a></li> <li><a href="/wiki/Herpes_simplex_research" title="Herpes simplex research">Herpes simplex</a></li> <li><a href="/wiki/HIV_vaccine_development" title="HIV vaccine development">HIV</a></li> <li><a href="/wiki/Zika_virus_vaccine" title="Zika virus vaccine">Zika</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Protozoan</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Malaria_vaccine" title="Malaria vaccine">Malaria</a> <ul><li><a href="/wiki/RTS,S" title="RTS,S">RTS,S</a></li></ul></li> <li>research: <ul><li><a href="/wiki/Trypanosomiasis_vaccine" title="Trypanosomiasis vaccine">Trypanosomiasis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Helminthiasis" title="Helminthiasis">Helminthiasis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>research: <ul><li><a href="/wiki/Hookworm_vaccine" title="Hookworm vaccine">Hookworm</a></li> <li><a href="/wiki/Schistosomiasis_vaccine" title="Schistosomiasis vaccine">Schistosomiasis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Androvax" title="Androvax">Androvax (androstenedione albumin)</a></li> <li><a href="/wiki/Cancer_vaccine" title="Cancer vaccine">Cancer vaccines</a> <ul><li><a href="/wiki/ALVAC-CEA_vaccine" title="ALVAC-CEA vaccine">ALVAC-CEA</a></li> <li><a href="/wiki/BCG_vaccine" title="BCG vaccine">BCG</a><sup>#</sup></li> <li><a href="/wiki/Hepatitis_B_vaccine" title="Hepatitis B vaccine">Hepatitis B</a><sup>#</sup></li> <li><a href="/wiki/HPV_vaccine" title="HPV vaccine">HPV</a><sup>#</sup> <ul><li><a href="/wiki/Cervarix" title="Cervarix">Cervarix</a></li> <li><a href="/wiki/Gardasil" title="Gardasil">Gardasil</a></li></ul></li> <li><a href="/wiki/Prostvac" title="Prostvac">Prostvac</a></li></ul></li> <li><a href="/wiki/NicVAX" title="NicVAX">NicVAX</a></li> <li><a href="/wiki/Ovandrotone_albumin" title="Ovandrotone albumin">Ovandrotone albumin (Fecundin)</a></li> <li><a href="/wiki/TA-CD" title="TA-CD">TA-CD</a></li> <li><a href="/wiki/TA-NIC" title="TA-NIC">TA-NIC</a></li> <li>combination: <ul><li><a href="/wiki/DTaP-IPV/Hib_vaccine" title="DTaP-IPV/Hib vaccine">DTaP-IPV/Hib</a></li> <li><a href="/wiki/DTaP-IPV-HepB_vaccine" title="DTaP-IPV-HepB vaccine">DTaP-IPV-HepB</a></li> <li><a href="/wiki/DTwP-HepB-Hib_vaccine" title="DTwP-HepB-Hib vaccine">DTwP-HepB-Hib</a></li> <li><a href="/wiki/Hexavalent_vaccine" title="Hexavalent vaccine">Hexavalent vaccine</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Inventors/<br />researchers</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Edward_Jenner" title="Edward Jenner">Edward Jenner</a></li> <li><a href="/wiki/Louis_Pasteur" title="Louis Pasteur">Louis Pasteur</a></li> <li><a href="/wiki/Hilary_Koprowski" title="Hilary Koprowski">Hilary Koprowski</a></li> <li><a href="/wiki/Jonas_Salk" title="Jonas Salk">Jonas Salk</a></li> <li><a href="/wiki/John_Franklin_Enders" title="John Franklin Enders">John Franklin Enders</a></li> <li><a href="/wiki/Maurice_Hilleman" title="Maurice Hilleman">Maurice Hilleman</a></li> <li><a href="/wiki/Stanley_Plotkin" title="Stanley Plotkin">Stanley Plotkin</a></li> <li><a href="/wiki/H._Fred_Clark" title="H. Fred Clark">H. Fred Clark</a></li> <li><a href="/wiki/Paul_Offit" title="Paul Offit">Paul Offit</a></li> <li><a href="/wiki/Katalin_Karik%C3%B3" title="Katalin Karikó">Katalin Karikó</a></li> <li><a href="/wiki/Drew_Weissman" title="Drew Weissman">Drew Weissman</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Controversy</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Vaccine_hesitancy" title="Vaccine hesitancy">General</a></li> <li><a href="/wiki/MMR_vaccine_and_autism" title="MMR vaccine and autism">MMR</a> (<a href="/wiki/Lancet_MMR_autism_fraud" title="Lancet MMR autism fraud"><i>Lancet</i> MMR autism fraud</a>)</li> <li><a href="/wiki/National_Childhood_Vaccine_Injury_Act" title="National Childhood Vaccine Injury Act">NCVIA</a></li> <li><a href="/wiki/Pox_party" title="Pox party">Pox party</a></li> <li><a href="/wiki/Thiomersal_and_vaccines" title="Thiomersal and vaccines">Thiomersal</a></li> <li><a href="/wiki/Vaccines_and_SIDS" title="Vaccines and SIDS">Vaccines and SIDS</a></li> <li><i><a href="/wiki/Cedillo_v._Secretary_of_Health_and_Human_Services" title="Cedillo v. Secretary of Health and Human Services">Cedillo v. Secretary of Health and Human Services</a></i></li> <li><a href="/wiki/Alternative_vaccination_schedule" title="Alternative vaccination schedule">Alternative vaccination schedule</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Epidemiology" title="Epidemiology">Epidemiology</a></li> <li><a href="/wiki/Eradication_of_infectious_diseases" title="Eradication of infectious diseases">Eradication of infectious diseases</a></li> <li><a href="/wiki/Vaccinate_Your_Family" title="Vaccinate Your Family">Vaccinate Your Family</a></li> <li><a href="/wiki/List_of_vaccine_topics" title="List of vaccine topics">List of vaccine topics</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="background: transparent; padding: 0px;"><div><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox authority-control" aria-label="Navbox" style="padding:3px"><table class="nowraplinks hlist navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a>: National <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q1810913#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://d-nb.info/gnd/4391579-6">Germany</a></span></li></ul></div></td></tr></tbody></table></div> <!-- NewPP limit report Parsed by mw‐web.codfw.main‐f69cdc8f6‐67nx9 Cached time: 20241122142711 Cache expiry: 2592000 Reduced expiry: false Complications: [vary‐revision‐sha1, show‐toc] CPU time usage: 1.186 seconds Real time usage: 1.323 seconds Preprocessor visited node count: 5205/1000000 Post‐expand include size: 220374/2097152 bytes Template argument size: 1915/2097152 bytes Highest expansion depth: 14/100 Expensive parser function count: 5/500 Unstrip recursion depth: 1/20 Unstrip post‐expand size: 307512/5000000 bytes Lua time usage: 0.739/10.000 seconds Lua memory usage: 5902244/52428800 bytes Number of Wikibase entities loaded: 1/400 --> <!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 1167.050 1 -total 61.56% 718.418 1 Template:Reflist 41.01% 478.571 48 Template:Cite_journal 9.66% 112.760 1 Template:Vaccines 7.52% 87.750 1 Template:Short_description 5.00% 58.384 6 Template:Citation 4.69% 54.682 2 Template:Pagetype 4.39% 51.215 1 Template:Scholia 4.16% 48.584 1 Template:Side_box 3.84% 44.869 1 Template:Authority_control --> <!-- Saved in parser cache with key enwiki:pcache:idhash:11365279-0!canonical and timestamp 20241122142711 and revision id 1240395279. 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