Applying lessons learned from cytomegalovirus infection in transplant patients to vaccine design

•Immunological variables that correlate with virus suppression have been identified.•Studies in transplant patients could facilitate the identification of clinical trial endpoints.•Emerging omics technologies have potential for identifying high value antigens.

Studies in transplant recipients over the past decade aiming to characterize the immune response to cytomegalovirus (CMV) replication have provided insights that can be used to guide CMV vaccine development. These studies have characterized multiple aspects of the immune response to virus infection in humans, and have identified immunologic variables that correlate with the ability to control virus replication. These findings can be used to guide vaccine development by informing decisions regarding antigen selection and the type of immune response that must be elicited by these antigens to promote protective immunity. In addition, these studies have provided information that could aid in the identification of immunologic endpoints in vaccine clinical trials, thus facilitating their design and implementation.