The development of effective vaccines holds out the most immediate hope for the future to the scientist whose job it is to discover new knowledge about VD, who has accepted the fact of failure of control by all means now available, and who feels incapable of dealing with the "social factors," whose importance he fully recognizes. So work on vaccines goes forward, but there are formidable obstacles. Technical difficulties peculiar to gonorrhea and syphilis, different for the two, make the prospect of success for either disease less than dazzling. The unpleasantness and unpopularity of the VD problem make it unlikely that the resources of a crash program, including the required funds, will be focused on it. And for reasons parallel with both of these difficulties for both technical and nontechnical reasons there is some doubt that we could make use of effective immunizing agents even if we had them.

To understand the general outlines of the problem of vaccines for VD, we had better begin with a few principles as they apply to the general subject of immunization. Before the great victory over polio in the mid 1950s there were only a few really effective vaccines. For general domestic human use in this country we could have begun and ended the list with vaccines against smallpox, diphtheria, tetanus, and whooping cough. For use in special\ circumstances, including foreign travel, occupational hazards, and other things, there were several others, among which only yellow fever vaccine compared in value with the first three. But since the success with polio vaccines several additional ones have emerged, nearly all the strikingly effective ones being for virus diseases, including measles, rubella, and mumps. Be it noted that some other vaccines -- against the typhus group of fevers, and against typhoid and related diseases, cholera, and plague, none of which are new, and all of which have been improved in some degree do not rank in effectiveness with those listed. They have value and are recommended for use under appropriate circumstances; but control of the disease in each instance is based mainly on something other than immunization, like destruction of insects or purification of water supplies. On the other hand, control of diphtheria, tetanus, smallpox, polio, and whooping cough, as well as of yellow fever among travelers, is squarely based on immunization. (see THE CHANCE FOR VD VACCINES PART II)