Outlook in 2019

In 1796, English physician Edward Jenner introduced the first vaccine, for smallpox, when he infected a young boy with cowpox. In the years since, vaccines — a name derived from the Latin word for cow — have been developed for many diseases, saving millions of lives. But the fight to conquer infectious disease continues.

Vaccination is a life-saving intervention, infections that once killed millions are now preventable. But there is still work to be done, many pathogens remain and there are still infections against which we have little defence.

Microbiologist Jeffrey Bethony details progress in efforts to protect people from hookworms and schistosomiasis.

As the first vaccine against the malaria parasite begins to roll out, scientists are working on a wide variety of alternatives that they hope will provide more protection.

Anthropologist Heidi Larson calls for dialogue to reassure people about the safety and efficacy of vaccines.

A vaccine candidate for HIV steps into phase III trials, signs emerge that antibiotics impair vaccine performance, and other highlights from clinical trials and laboratory studies.

When immunization rates dip, legislation is often strengthened. But does the evidence stack up?

Infants and those over 65 are at the highest risk of infectious disease. A better understanding of age-specific immunity is needed to design vaccines that work for them.

Passing on short-term immunity to offspring is common in vertebrates, but plants and invertebrates take transgenerational immunity much further.

As the seas rise, our understanding of the processes within them must deepen.

To predict how much climate change will raise sea level, researchers are studying ice shelves — where vast expanses of ice meet the ocean.

Models of the behaviour of the oceans with higher spatial resolution could lead to more accurate climate predictions.

With more than a dozen RNA therapies being tested in clinical trials, patients with many previously untreatable conditions have cause for optimism.

Researchers hope that understanding the many roles of non-coding RNA in heart health and cardiovascular disease could deliver a therapeutic breakthrough.

After a groundswell of hype and a sceptical backlash, the pharmaceutical industry is learning how to leverage RNA interference in the clinic.

Delivery difficulties brought the nascent research field to its knees, but approval of the first RNA interference drug offers hope.

As a source of potential treatments, gene editing gets all the attention. That needs to change, argues Lorna Harries.

The technology could help to boost immunity against cancer, influenza and much more.

Treatments that target RNA or deliver it to cells fall into three broad categories, with hybrid approaches also emerging.

Carlos Heras-Palou explains his part in making the first RNA-interference therapeutic available to people with rare diseases.