ArticleProceedings of the National Academy of Sciences of the United States of America2018
Why the evolution of vaccine resistance is less of a concern than the evolution of drug resistance.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers.
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Who cites it
65 citing papers in PubMed, 151 citations in OpenAlex.
- Environmental drivers of low vaccine responsiveness in a lab-to-wild rodent model.PLoS pathogens · 2026Article
- Comparing the Risk of SARS-CoV-2 Immune Resistance Evolving Across Regions in the Americas with Differing Approaches to Public Health.Pathogens (Basel, Switzerland) · 2026Article
- Fluorinated carbohydrate-based vaccines.Chemical science · 2026Review
- Developing monoclonal antibody therapies for measles could lead to adverse pathogen evolution.PLoS biology · 2026Article
- Voxtalisib inhibits enterovirus 71 replication by downregulating host RAN and restoring IFN-STAT signaling.Journal of advanced research · 2026Article
- A Nasal Spray Combining Camostat with a Natural Polysaccharide for the Prevention of Viral Infection via Nasal Mucosal Barrier Formation and Entry Inhibition.International journal of molecular sciences · 2026Article
- From Antibiotic Resistance to Bacterial Vaccines: A New Approach to Controlling Resistant Bacterial Infections.Infection and drug resistance · 2026Review
- No innocent bystanders: pertussis vaccination and evolutionary parallelisms betweenMicrobial genomics · 2025Article
- An analytic approach considering two temporal mechanisms driving breakthrough viral infections after vaccination.Vaccine · 2025Article
- Understanding the traits underlying vaccine-driven virulence evolution in malaria parasites.BMC biology · 2025Article
- Reconstructing the Antibiotic Pipeline: Natural Alternatives to Antibacterial Agents.Biomolecules · 2025Review
- Intranasal delivery of mRNA expressing newly identified Acinetobacter baumannii antigens protects against bacterial lung disease.NPJ vaccines · 2025Article
- The speed of vaccination rollout and the risk of pathogen adaptation.Journal of the Royal Society, Interface · 2025Article
- Article
- Evolution of Antiviral Drug Resistance in SARS-CoV-2.Viruses · 2025Review
- Epitope mapping of recombinant Salmonella enterica serotype Heidelberg flagellar hook-associated protein by in silico and in vivo approaches.BMC veterinary research · 2025Article
- Article
- Cohort-resolved excess mortality in Germany (2000-2024): Patterns and implications for the SARS-CoV-2 era.PloS one · 2025Article
- A multi-epitope vaccine targeting a key virulence factor ClfA: An In-silico approach to combat Staphylococcus aureus infections.PloS one · 2025Article
- Enhancing vaccine effectiveness in the elderly to counter antibiotic resistance: The potential of adjuvants via pattern recognition receptors.Human vaccines & immunotherapeutics · 2024Review
5 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
Vaccines and antimicrobial drugs both impose strong selection for resistance. Yet only drug resistance is a major challenge for 21st century medicine. Why is drug resistance ubiquitous and not vaccine resistance? Part of the answer is that vaccine resistance is far less likely to evolve than drug resistance. But what happens when vaccine resistance does evolve? We review six putative cases. We find that in contrast to drug resistance, vaccine resistance is harder to detect and harder to confirm and that the mechanistic basis is less well understood. Nevertheless, in the cases we examined, the pronounced health benefits associated with vaccination have largely been sustained. Thus, we contend that vaccine resistance is less of a concern than drug resistance because it is less likely to evolve and when it does, it is less harmful to human and animal health and well-being. Studies of pathogen strains that evolve the capacity to replicate and transmit from vaccinated hosts will enhance our ability to develop next-generation vaccines that minimize the risk of harmful pathogen evolution.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.