Respiratory Syncytial Virus Prevention within Reach: The Vaccine and Monoclonal Antibody Landscape
Date
2023-01-23
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Abstract
Respiratory syncytial virus (RSV) is the second most common cause of infant mortality and
an important cause of morbidity and mortality in older adults. Efforts to develop an RSV
vaccine or immunoprophylaxis remain highly active. Thirty-three RSV prevention candidates
are in clinical development using six different approaches: recombinant vector, subunit, particlebased, live-attenuated, chimeric, and nucleic acid in addition to monoclonal antibodies (mAbs).
Eight candidates are in phase III clinical trials. Understanding the epitopes targeted by highly
neutralizing antibodies has resulted in a shift from empirical to rational and structure-based
vaccine and mAb design. An extended half-life mAb for all infants is likely within one year
of regulatory approval for high income countries. Live-attenuated vaccines are in development
for older infants. Subunit vaccines are in late-stage trials for pregnant women to protect infants,
while vector, subunit and nucleic acid approaches are being developed for older adults. Urgent
next steps include ensuring access and affordability of an RSV vaccine globally. This review
gives an overview of RSV vaccines and mAbs in clinical development highlighting different target
populations, antigens, and latest trial results.
Description
Keywords
respiratory syncytial virus; vaccines