Respiratory syncytial virus vaccination: likely and less likely outcomes

Respiratory syncytial virus (RSV) remains a leading cause of lower respiratory tract infections in infants, older adults, and high-risk populations. The recent approval of new RSV vaccines and monoclonal antibodies marks a turning point in RSV prevention. This review explores these advancements, their immediate and potential long-term effects, and the remaining challenges.

Several novel RSV prevention strategies have been approved, including maternal RSVPreF vaccines, infant-targeted monoclonal antibodies like Nirsevimab, and vaccines for older adults. These interventions significantly reduce RSV-related hospitalizations, ICU admissions, and mortality, particularly in high-risk groups. Early evidence also suggests benefits in reducing wheezing during infancy; however, long-term impacts on asthma development remain uncertain. Challenges such as vaccine hesitancy and limited access in low-resource settings remain pressing issues that require sustained focus.

RSV vaccines and monoclonal antibodies are expected to alter clinical management and public health by reducing severe disease burden and RSV transmission. Further research is needed to evaluate their long-term effects, including implications for asthma prevention and pediatric obstructive sleep apnea. Addressing access disparities and public acceptance will be critical for maximizing their global impact.