Vaccines for protecting infants from bacterial causes of diarrheal disease

Richard Walker*, Robert W. Kaminski, Chad Porter, Robert K.M. Choy, Jessica A. White, James M. Fleckenstein, Fred Cassels, Louis Bourgeois

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations


The global diarrheal disease burden for Shigella, enterotoxigenic Escherichia coli (ETEC), and Campylobacter is estimated to be 88M, 75M, and 75M cases annually, respectively. A vaccine against this target trio of enteric pathogens could address about one-third of diarrhea cases in children. All three of these pathogens contribute to growth stunting and have demonstrated increasing resistance to antimicrobial agents. Several combinations of antigens are now recognized that could be effective for inducing protective immunity against each of the three target pathogens in a single vaccine for oral administration or parenteral injection. The vaccine combinations proposed here would result in a final product consistent with the World Health Organization’s (WHO) preferred product characteristics for ETEC and Shigella vaccines, and improve the vaccine prospects for support from Gavi, the Vaccine Alliance, and widespread uptake by low-and middle-income countries’ (LMIC) public health stakeholders. Broadly protective antigens will enable multi-pathogen vaccines to be efficiently developed and cost-effective. This review describes how emerging discoveries for each pathogen component of the target trio could be used to make vaccines, which could help reduce a major cause of poor health, reduced cognitive development, lost economic productivity, and poverty in many parts of the world.

Original languageEnglish
Article number1382
Issue number7
StatePublished - Jul 2021
Externally publishedYes


  • Adjuvants
  • Campylobacter vaccine
  • Disease burden
  • ETEC vaccine
  • Models of disease
  • Mucosal immunity
  • Multi-pathogen enteric vaccines
  • Shigella vaccine
  • Stunting


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