Considerations for combination vaccine development and use in the developing world

As more vaccines are developed and become available, combination vaccines w ill provide a way of delivering multiple antigens to avoid multiple injecti ons and complications in the regular immunization schedules. The advantages of combination vaccines are that they decrease the discomfort of vaccine r ecipients and parents and also reduce the delivery cost of vaccines. We add ress some of the issues related to the use of combination vaccines in the d eveloping world. Which vaccines are needed? Do developing countries have th e appropriate infrastructure to deliver them? Can vaccines become affordabl e for countries with low incomes? And what is really needed to achieve the goal of providing developing countries with new vaccines of epidemiologic s ignificance in a timely fashion?