Yow and Demmler published an editorial in 1992 entitled Congenital cytomegalovirus disease--20 years is long enough. This editorial pointed out that, despite the long-standing recognition of the major public health importance of congenital human cytomegalovirus (CMV) infection, few solutions had been forthcoming. In no area has the lack of progress been more frustrating than in the realm of CMV vaccine development. Although a number of vaccine strategies have been considered, few have advanced to the stage of efficacy testing.