“…Indeed, the entire production process from fermentation to final purified GMMA lasts 3 days and thus, depending on the size of the vaccine dose, a relatively small manufacture facility with a 500 L fermenter could produce 100 000 000 doses of vaccines per year at a manufacturing cost of approximately $1 per dose (10). GMMA from Shigella (4,5,7,9,(11)(12)(13), Salmonella (8,14,15), and Neisseria (16,18) species have been already generated using this approach, which is shown to be flexible enough to be potentially extended with minimal adjustments to any Gram-negative bacterial species. Indeed multiple industrial (17)(18)(19) and research (20)(21)(22) approaches based on genetic engineering of bacteria for hyper-vesiculating and surface-expression of a variety of homologous and heterologous antigens, including bacterial (20)(21)(22), viral (23), parasitic (24) and even cancer antigens (25) have been described.…”