LAUSR

Vaccines are the most effective health intervention and it has been estimated that they will save approximately 25 million deaths over 10 years from 2010 to 2020, which is equivalent to five lives saved /minute [1]. Vaccination has played a major role in the unprecedented increase in life expectancy, from 40 to over 80 years, which has occurred in developed countries in 100 years. To have a sense of the drama of polio or other infectious diseases in the western wealthy world, one has to resort to literature, for instance the novel Nemesis by Philip Roth. In spite of the dramatic impact of vaccines on human health and of progress made in understanding the immunology of vaccination and potential vaccination strategies as evidenced by recent reviews in the European Journal of Immunology [2–5] including one in this issue of the Journal [6], possibly involving trained innate immunity [7], and the successful development of new vaccines addressing unmet health needs [7–10], skepticism and sometimes overt hostility (the no-vax movement) have grown in western opulent countries. In sharp contrast, at a global level only one out of 6 children born on the planet has access to the full vaccine repertoire [11, 12]. The recent reintroduction of mandatory vaccination in Italy as a requirement to be able to attend school, preceeded by similar decisions in California [13] and other states in the USA, and followed by France, offers a chance for reflection on this apparent paradox.