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-Author Affiliations
1. *Infection and Immunity Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, Australia; 2. †School of Medicine, Flinders University, Bedford Park, South Australia, Australia; 3. ‡Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, California, USA; 4. §Department of Pathology, Stanford University School of Medicine, Stanford, California, USA; and 5. ¶Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, California, USAAfter clean water, vaccines are the primary public health intervention providing protection against serious infectious diseases. Antigen-specific antibody-mediated responses play a critical role in the protection conferred by vaccination; however these responses are highly variable among individuals. In addition, vaccine immunogenicity is frequently impaired in developing world populations, for reasons that are poorly understood. Although the factors that are associated with interindividual variation in vaccine responses are likely manifold, emerging evidence from mouse models and studies in human populations now suggests that the gut microbiome plays a key role in shaping systemic immune responses to both orally and parenterally administered vaccines. Herein, we review the evidence to date that the microbiota can influence vaccine responses and discuss the potential mechanisms through which these effects may be mediated. In addition, we highlight the gaps in this evidence and suggest future directions for research.