The SARS-CoV-2 epidemic is merely the most recent demonstration that our current approach to emerging zoonotic infectious disease is ineffective. SARS, MERS, Ebola, Nipah and an array of arenavirus infections sporadically spillover into human populations and are often contained only as a result of their poor transmission in human hosts, coupled with intense public health control efforts in the early stages of an emerging epidemic. It is now more apparent than ever that we need a better and more proactive approach. One possibility is to eliminate the threat of spillover before it occurs using vaccines capable of autonomously spreading through wild animal reservoirs. We are now poised to begin developing self-disseminating vaccines targeting a wide range of human pathogens, but important decisions remain about how they can be most effectively designed and used to target pathogens with a high risk of spillover and/or emergence. In this Perspective, we first review the basic epidemiological theory establishing the feasibility and utility of self-disseminating vaccines. We then outline a road map for overcoming remaining technical challenges: identifying high-risk pathogens before they emerge, optimizing vaccine design with an eye to evolution, behaviour and epidemiology, and minimizing the risk of unintended consequences.

SARS-CoV-2 疫情只是最近一次证明，我们目前对新出现的人畜共患传染病的方法是无效的。SARS、中东呼吸综合征、埃博拉病毒、尼帕病毒和一系列沙粒病毒感染偶尔会蔓延到人群中，并且通常只是由于它们在人类宿主中传播不良，再加上在新出现的流行病的早期阶段进行了密集的公共卫生控制工作，才得以遏制。现在比以往任何时候都更明显的是，我们需要一种更好、更主动的方法。一种可能性是使用能够通过野生动物水库自主传播的疫苗在溢出威胁发生之前消除它。我们现在准备开始开发针对多种人类病原体的自我传播疫苗，但是关于如何最有效地设计和使用它们来针对具有高溢出和/或出现风险的病原体仍然存在重要的决定。在本文中，我们首先回顾了确定自我传播疫苗的可行性和实用性的基本流行病学理论。然后，我们概述了克服剩余技术挑战的路线图：在高风险病原体出现之前识别它们，从进化、行为和流行病学的角度优化疫苗设计，并将意外后果的风险降至最低。