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Respiratory syncytial virus vaccines
1Department of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA.
Insights
Developing effective respiratory syncytial virus (RSV) vaccines is crucial for preventing severe illness in infants and the elderly. Promising candidates include purified F protein subunit vaccines and live attenuated vaccines, with ongoing research to refine them.
Area of Science:
- Virology
- Immunology
- Vaccinology
Background:
- Respiratory syncytial virus (RSV) is a primary cause of viral lower respiratory tract illness (LRI) globally, particularly impacting infants, children, the elderly, and immunocompromised individuals.
- Developing a successful RSV vaccine faces challenges including inadequate infant immune responses, distinct RSV groups (A and B), and historical vaccine-related disease enhancement.
- Preventing serious RSV-associated LRI is the primary objective of RSV vaccination strategies.
Purpose of the Study:
- To review the current landscape and challenges in developing effective respiratory syncytial virus (RSV) vaccines.
- To evaluate the potential of different vaccine platforms, including subunit and live attenuated approaches, for various at-risk populations.
- To discuss the role of advanced technologies like cDNA in refining vaccine candidates.
Main Methods:
- Review of existing literature on RSV vaccine development, clinical trials, and candidate evaluation.
- Analysis of different vaccine types, including purified F protein (PFP) subunit vaccines and live attenuated vaccines.
- Consideration of specific populations at risk and their unique vaccination needs.
Main Results:
- Purified F protein (PFP) subunit vaccines, such as PFP-2, show promise for the elderly and RSV-seropositive children with pulmonary conditions.
- Live cold-passaged (cp), temperature-sensitive (ts) RSV vaccines (cpts vaccines) are identified as potentially suitable for young infants.
- Ongoing research aims to refine live attenuated cpts vaccines using cDNA technology for improved attenuation, immunogenicity, and stability.
Conclusions:
- Multiple vaccine types may be necessary to effectively prevent RSV LRI across diverse populations.
- Advancements in vaccine technology, particularly cDNA, offer opportunities to engineer more effective and stable live attenuated RSV vaccines.
- Targeted vaccine strategies are essential for protecting vulnerable groups from severe RSV disease.
Abstract:
Respiratory syncytial virus (RSV) is the most important cause of viral lower respiratory tract illness (LRI) in infants and children worldwide and causes significant LRI in the elderly and in immunocompromised patients. The goal of RSV vaccination is to prevent serious RSV-associated LRI. There are several obstacles to the development of successful RSV vaccines, including the need to immunize very young infants, who may respond inadequately to vaccination; the existence of two antigenically distinct RSV groups, A and B; and the history of disease enhancement following administration of a formalin-inactivated vaccine. It is likely that more than one type of vaccine will be needed to prevent RSV LRI in the various populations at risk. Although vector delivery systems, synthetic peptide, and immune-stimulating complex vaccines have been evaluated in animal models, only the purified F protein (PFP) subunit vaccines and live attenuated vaccines have been evaluated in recent clinical trials. PFP-2 appears to be a promising vaccine for the elderly and for RSV-seropositive children with underlying pulmonary disease, whereas live cold-passaged (cp), temperature-sensitive (ts) RSV vaccines (denoted cpts vaccines) would most probably be useful in young infants. The availability of cDNA technology should allow further refinement of existing live attenuated cpts candidate vaccines to produce engineered vaccines that are satisfactorily attenuated, immunogenic, and phenotypically stable.