A respiratory syncytial virus vaccine (RSV vaccine) is a

vaccine A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified.

which prevents infection by

respiratory syncytial virus Respiratory syncytial virus (RSV), also called human respiratory syncytial virus (hRSV) and human orthopneumovirus, is a common, contagious virus that causes infections of the respiratory tract. It is a negative-sense, single-stranded RNA virus. ...

. , no licensed vaccine against RSV exists. Attempts to develop an RSV vaccine began in the 1960s with an unsuccessful

inactivated vaccine An inactivated vaccine (or killed vaccine) is a vaccine consisting of virus particles, bacteria, or other pathogens that have been grown in culture and then killed to destroy disease-producing capacity. In contrast, live vaccines use pathogens ...

developed by exposing the RSV virus to

formalin Formaldehyde ( , ) ( systematic name methanal) is a naturally occurring organic compound with the formula and structure . The pure compound is a pungent, colourless gas that polymerises spontaneously into paraformaldehyde (refer to section F ...

(formalin-inactivated RSV (FI-RSV)). This vaccine induced a phenomenon that came to be known as

vaccine-associated enhanced respiratory disease Vaccine-associated enhanced respiratory disease (VAERD), or simply enhanced respiratory disease (ERD), refers to an adverse event where an exacerbated course of respiratory disease occurs with higher incidence in the vaccinated population in com ...

(VAERD), in which children who had not previously been exposed to RSV and were subsequently vaccinated would develop a severe form of RSV disease if exposed to the virus itself, including

fever Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...

wheezing A wheeze is a continuous, coarse, whistling sound produced in the respiratory airways during breathing. For wheezes to occur, some part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract ...

, and

bronchopneumonia Bronchopneumonia is a subtype of pneumonia. It is the acute inflammation of the bronchi, accompanied by inflamed patches in the nearby lobules of the lungs. citing: Webster's New World College Dictionary, Fifth Edition, Copyright 2014 It is ofte ...

. Some eighty percent of such children (vs. 5% of virus-exposed controls) were hospitalized, and two children died of lethal lung inflammatory response during the first natural RSV infection after vaccination of RSV-naive infants. This disaster hindered vaccine development for many years to come. A 1998 paper reported that research toward developing a vaccine had advanced greatly over the previous 10 years. The desired vaccine would prevent lower respiratory infection from RSV in at-risk populations and if possible be useful in other populations with less risk. Twenty years later, a 2019 paper similarly claimed that research toward developing a vaccine had advanced greatly over the prior 10 years. The same study predicted that a vaccine would be available within 10 years. The current types of vaccines which are in research are particle-based vaccines, attenuated vaccines,

mRNA vaccines An mRNA vaccine is a type of vaccine that uses a copy of a molecule called messenger RNA (mRNA) to produce an immune response. The vaccine delivers molecules of antigen-encoding mRNA into immune cells, which use the designed mRNA as a blueprin ...

, protein subunit vaccines, or vector-based vaccines. A vaccine called GSK3888550A and developed by GlaxoSmithKline (GSK) entered phase 3 clinical trials in November 2020. Barney S. Graham and Peter Kwong of the

National Institute of Allergy and Infectious Diseases The National Institute of Allergy and Infectious Diseases (NIAID, ) is one of the 27 institutes and centers that make up the National Institutes of Health (NIH), an agency of the United States Department of Health and Human Services (HHS). NIAID's ...

Vaccine Research Center The Vaccine Research Center (VRC), is an intramural division of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), US Department of Health and Human Services (HHS). The mission of ...

, along with

Jason McLellan Jason S. McLellan is a structural biologist, professor in the Department of Molecular Biosciences and Robert A. Welch Chair in Chemistry at The University of Texas at Austin who specializes in understanding the structure and function of viral prot ...

, a former postdoctoral researcher at VRC and a professor at The University of Texas at Austin, spearheaded its development. The vaccine's antigen, a stabilized version of the RSV F protein, was developed using structure-based vaccine design. In August 2021,

Moderna Moderna, Inc. ( ) is an American pharmaceutical and biotechnology company based in Cambridge, Massachusetts that focuses on RNA therapeutics, primarily mRNA vaccines. These vaccines use a copy of a molecule called messenger RNA (mRNA) to pro ...

received US FDA fast track designation for their Respiratory Syncytial Virus Vaccine. As of October 10, 2022, at least four companies are testing candidate RSV vaccines based on stabilized prefusion F proteins in older adults in Phase 3 trials:

GSK plc GSK plc, formerly GlaxoSmithKline plc, is a British multinational pharmaceutical and biotechnology company with global headquarters in London, England. Established in 2000 by a merger of Glaxo Wellcome and SmithKline Beecham. GSK is the tent ...

Pfizer Pfizer Inc. ( ) is an American multinational pharmaceutical and biotechnology corporation headquartered on 42nd Street in Manhattan, New York City. The company was established in 1849 in New York by two German entrepreneurs, Charles Pfizer ...

, Johnson & Johnson, and

References

{{Vaccines Vaccines Viral respiratory tract infections