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Immune Mechanisms Underlying Neonatal Protection Following Maternal RSV Vaccination

Aikaterini I Nikolaou1,2, Vasileios Giapros2, Maria Alexandra Kefala2

  • 1Department of Pediatrics, School of Medicine, University of Ioannina, 45500 Ioannina, Greece.

International Journal of Molecular Sciences
|July 28, 2026
PubMed

Insights

Maternal respiratory syncytial virus (RSV) vaccination protects newborns via antibodies transferred across the placenta. This review explores how these antibodies, including IgG subclasses and Fc glycosylation, ensure neonatal immunity.

Area of Science:

  • Immunology
  • Vaccinology
  • Neonatal Health

Background:

  • Respiratory syncytial virus (RSV) is a leading cause of severe infant respiratory infections.
  • Infants possess immunological immaturity, limiting their intrinsic antiviral responses.
  • Maternal vaccination offers a promising strategy for neonatal protection against RSV.

Purpose of the Study:

  • To review mechanisms of maternally derived antibody-mediated neonatal protection against RSV.
  • To elucidate the role of FcRn, IgG subclasses, and Fc glycosylation in antibody transfer and function.
  • To identify factors influencing neonatal antibody levels and passive immunity duration.

Main Methods:

  • Review of current literature on maternal RSV vaccination and neonatal immunity.
  • Analysis of FcRn-mediated transplacental transport mechanisms.
  • Examination of IgG subclass-specific transfer and half-life.
  • Investigation of Fc glycosylation's role in Fcγ receptor interactions.

Main Results:

  • Maternal vaccination induces high-titer, prefusion F-specific IgG1 antibodies for placental transfer.
  • FcRn-mediated transport and IgG subclass influence antibody levels and persistence.
  • Fc glycosylation impacts Fcγ receptor engagement and Fc-dependent effector functions.
  • Both neutralization and Fc-dependent mechanisms contribute to neonatal protection.

Conclusions:

  • Understanding antibody transport and effector functions is crucial for optimizing maternal RSV immunization.
  • Factors like vaccination timing, antibody characteristics, and placental integrity are key determinants of neonatal immunity.
  • Further research is needed to clarify selective placental transfer pathways and optimize strategies for early-life protection.

Keywords:
Fc-mediated effector functionsFcRnIgGantibody glycosylationmaternal immunizationneonatal immunitypassive immunityrespiratory syncytial virustransplacental antibody transfervaccination timing

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