What’s Next? The vaccine pipeline is more diverse than ever, driven by advances in immunology, molecular biology and data-rich surveillance. Some of the most tangible near-term gains are in respiratory disease. “RSV has a huge burden in children and the elderly each winter,” Dr. Sadarangani says. “Canada now has programs using vaccination in pregnancy to protect infants, and monoclonal antibodies for newborns. We should see less RSV in the coming years.” Maternal immunization is a growing frontier. Group B Streptococcus, a leading cause of neonatal sepsis and meningitis, has entered large phase 3 trials as a vaccine given in pregnancy to protect babies in their first weeks of life. Global health priorities remain front and centre. Dr. Halperin points to sustained efforts against meningococcal disease, now with quadrivalent vaccines and growing use of serogroup B products in adolescents, and in some programs for infants. Zika sparked vaccine development during outbreaks in the Americas. Malaria vaccines have begun rollout, with additional candidates in the pipeline. “The malaria vaccine is effective, but not 100%,” Dr. Halperin says. “Even 40–50% effectiveness can prevent a large amount of severe disease and death in high-burden settings. We’d like to improve it, but it’s already meaningful.” The field is also preparing for the next pandemic. Avian influenza has crossed species into cattle and has caused rare human infections. “It wouldn’t take many mutations to gain efficient human transmission,” Dr. Halperin says. “We’re always considering infections of pandemic potential, working to predict them and develop vaccines in advance.” Meanwhile, the hardest problems continue to demand new ideas. “There are vaccines that we’ve been working on for decades without success,” Dr. Halperin says, citing HIV’s extraordinary capacity to evade immune recognition. Here, platform diversity is a strategic asset. mRNA and other nucleic-acid technologies can shorten design cycles, enable rapid updates to match evolving strains, and present complex antigens that are difficult to manufacture as proteins. “Our range of technology has expanded,” he says. “That lets us pursue a broader set of pathogens and provide options for people who may not respond well to one type of vaccine.” Image: Public Health Agency of Canada 24 | 2026 | Issue 2 Issues and People
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