Human cytomegalovirus (HCMV) is the most common congenitally transmitted pathogen worldwide, impacting an estimated 1 million newborns annually. Congenital HCMV (cCMV) infection is a major global contributor to long-term neurologic deficits, including deafness, microcephaly, and neurodevelopmental delay, as well as to fetal loss and occasional infant mortality. Accordingly, design of a maternal vaccine to prevent cCMV continues to be a top public health priority. Nevertheless, we remain without a licensed vaccine. Maternal immunity provides partial protection, as the risk of vertical HCMV transmission from chronically infected mothers is reduced compared to settings in which the mother is newly infected during pregnancy. Therefore, an understanding of the maternal immune correlates of protection against cCMV is critical to informing design of an efficacious maternal vaccine. Although vaccine development is being assiduously pursued by a large number of pharmaceutical manufacturers, biotechnology organizations, and academic researchers, some pessimism has been expressed regarding the issue of whether a vaccine to protect against cCMV is possible. This pessimism is based on observations that natural immunity is not completely protective against maternal reinfection and congenital transmission. However, we assert that optimism regarding vaccine development is indeed justified, on the basis of accruing evidence of immune correlates of protection—readily achievable by vaccination—that are associated with reduced transmission of HCMV to the fetus in seronegative women. In light of the substantial burden on society conferred by cCMV infection, even a modest reduction in the occurrence of this fetal disease is an important public health goal and justifies aggressive clinical evaluation of vaccines currently in the pipeline.

人类巨细胞病毒（HCMV）是全球最常见的先天传播病原体，估计每年影响100万新生儿。先天性HCMV（cCMV）感染是导致长期神经功能缺损（包括耳聋，小头畸形和神经发育迟缓）以及胎儿丢失和偶发性婴儿死亡的主要全球因素。因此，设计预防cCMV的孕产妇疫苗仍然是公共卫生的重中之重。尽管如此，我们仍然没有获得许可的疫苗。孕产妇的免疫力提供了部分保护，因为与怀孕期间新感染母亲的环境相比，慢性感染母亲从垂直HCMV传播的风险有所降低。所以，了解针对cCMV的母体免疫保护相关性对于设计有效的母体疫苗至关重要。尽管许多药物制造商，生物技术组织和学术研究人员都在积极地开发疫苗，但对于是否有可能针对cCMV的疫苗，人们已经表示了一些悲观情绪。这种悲观主义是基于以下观察结果：自然免疫不能完全防止产妇再感染和先天性传播。但是，我们认为，根据越来越多的保护性免疫相关证据（很容易通过疫苗接种实现），对疫苗开发的乐观态度是有道理的，而这些相关性与血清阴性妇女中HCMV向胎儿的传播减少有关。