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Salem Health: Infectious Diseases & Conditions, 2nd Edition

Cytomegalovirus vaccine

by Janet Ober Berman, , M.S., CGC

Category: Prevention

Definition

No vaccine exists for cytomegalovirus (CMV) infection, the most common congenital infection in the United States. Severely affected newborns may have hearing loss, vision loss, mental retardation, cerebral palsy, seizures, and liver disease. CMV is also frequently acquired in immunocompromised persons, such as those with human immunodeficiency virus (HIV) infection or cancer and those who have had organ transplants. Persons with compromised immune systems are consequently at risk for developing additional life-threatening infections.

CMV is primarily spread by contact with young children who excrete the virus. Earlier attempts to prevent CMV transmission by increased hygienic practices, such as handwashing and avoiding handling of children, proved unsuccessful, and antiviral medications have low efficacy. Therefore, in 1999 the Institute of Medicine listed CMV vaccine development as its top new vaccine priority for the twenty-first century.

Potential CMV Vaccines

Pregnant women without a history of CMV infection and who have close contact with young children are at greatest risk of contracting the virus and transmitting it to a fetus. Therefore, the primary goal of the CMV vaccine would be to give at-risk women immunity to the virus before giving birth. Several potential vaccine candidates, including the Towne and MF59 vaccines, are in clinical trials. Antibodies from the Towne vaccine were detected eighty-four months after administration, demonstrating long-term established immunity. Additionally, the MF59 vaccine showed 50 percent efficacy for preventing disease transmission; there was one case of congenital CMV reported after vaccination.

Immunocompromised persons are at risk of reactivating an old infection. The Towne vaccine protected kidney transplant patients from developing symptoms, although it did not prevent the acquisition of CMV. Another vaccine, TransVax, boosted immunity and reduced reactivation of the virus in immunocompromised persons. While promising, these vaccines all require further research.

Development Challenges

All vaccines have been shown to be safe, but studies are limited by difficulty in recruiting study subjects because of a lack of public awareness of CMV, by the need for a large sample size, and by the need for long-term follow-up. Additionally, many women enrolled in vaccine trials have increased their handwashing frequency and have decreased exposure to young children, making it difficult to determine if the vaccine, or the change in behavior, is determining outcome. Also, debate remains about what population should be targeted for vaccine administration.

Impact

Approximately eight thousand newborns annually have severe medical and neurological concerns related to congenital CMV infection, translating into a yearly national health care cost of $1.86 billion. An effective CMV vaccine not only would decrease the rate of infection but also would reduce the economic burden for treating the related diseases. Despite ongoing research efforts from the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, and National Institutes of Health, no approved CMV vaccine is available.

Further Reading

1 

Adler, Stuart, et al. “Recent Advances in the Prevention and Treatment of Congenital Cytomegalovirus Infections.” Seminars in Perinatology 31 (2007): 10-18.

2 

Arvin, Ann, et al. “Vaccine Development to Prevent Cytomegalovirus Disease: Report from the National Vaccine Advisory Committee.” Vaccines 39 (2004): 233-239.

3 

Dekker, Cornelia, and Ann Arvin. “One Step Closer to a CMV Vaccine.” New England Journal of Medicine 360 (2009): 1250-1252.

4 

Martin, Richard J., Avroy A. Fanaroff, and Michele C. Walsh, eds. Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 2 vols. 8th ed. Philadelphia: Mosby/Elsevier, 2006.

Web Sites of Interest

Center for the Evaluation of Risks to Human Reproduction

http://cerhr.niehs.nih.gov

March of Dimes

http://www.modimes.org

Pediatric Infectious Diseases Society

http://www.pids.org

Women’s Health Matters

http://www.womenshealthmatters.ca

See also: Breast milk and infectious disease; Childbirth and infectious disease; Children and infectious disease; Cytomegalovirus infection; Herpesviridae; Herpesvirus infections; HIV; Neonatal sepsis; Pregnancy and infectious disease; Vaccines: Experimental; Vaccines: Types; Viral infections; Women and infectious disease.

Citation Types

Type
Format
MLA 9th
Berman, Janet Ober. "Cytomegalovirus Vaccine." Salem Health: Infectious Diseases & Conditions, 2nd Edition, edited by H. Bradford Hawley, Salem Press, 2020. Salem Online, online.salempress.com/articleDetails.do?articleName=Infect2e_0157.
APA 7th
Berman, J. O. (2020). Cytomegalovirus vaccine. In H. B. Hawley (Ed.), Salem Health: Infectious Diseases & Conditions, 2nd Edition. Salem Press. online.salempress.com.
CMOS 17th
Berman, Janet Ober. "Cytomegalovirus Vaccine." Edited by H. Bradford Hawley. Salem Health: Infectious Diseases & Conditions, 2nd Edition. Hackensack: Salem Press, 2020. Accessed September 16, 2025. online.salempress.com.