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Maternal Respiratory Syncytial Virus (RSV) Vaccination: Current Status and Comparison to Monoclonal Antibodies (mAbs) for RSV Prevention in Infants and Children Cover

Maternal Respiratory Syncytial Virus (RSV) Vaccination: Current Status and Comparison to Monoclonal Antibodies (mAbs) for RSV Prevention in Infants and Children

Open Access
|Aug 2025

References

  1. Aliprantis AO, Shaw CA, Griffin P, Farinola N, Railkar RA, Cao X, et al. A phase 1, randomized, placebo-controlled study to evaluate the safety and immunogenicity of an mRNA-based RSV prefusion F protein vaccine in healthy younger and older adults. Hum. Vaccines Immunother. 2021;17(5):1248–1261.
  2. Shaw CA, Ciarlet M, Cooper BW, Dionigi L, Keith P, O'Brien KB, et al. The path to an RSV vaccine. Curr. Opin. Virol. 2013;3(3):332–342.
  3. Carroll KN, Wu P, Gebretsadik T, Griffin MRF, Dupont Wd, Mitchel EF, et al. The severity-dependent relationship of infant bronchiolitis on the risk and morbidity of early childhood asthma. J. Allergy Clin. Immunol. 2009;123(5):1055–1061, 1061.e1.
  4. Lozano, R. Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095–2128.
  5. Shi, T, McAllister DA, O'Brien KL, Simoes EA, Madhi SA, Gessner BD, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet Lond. Engl. 2017;390(10098):946–958.
  6. NIAID: National Institute of Allergy and Infectious Disease. Respiratory Syncytial Virus (RSV): https://www.niaid.nih.gov/diseases-conditions/respiratory-syncytial-virus-rsv.
  7. Falsey AR, Walsh EE. Respiratory syncytial virus infection in adults. 2000; Clin. Microbiol. Rev. 13(3):371–384.
  8. Battles, MB, McLellan, JS. Respiratory syncytial virus entry and how to block it. Nat. Rev. Microbiol. 2019; 17(4):233–245.
  9. Levine S, Klaiber-Franco R, Paradiso PR. Demonstration that glycoprotein G is the attachment protein of respiratory syncytial virus. J. Gen. Virol. 1987;68 (Pt 9):2521–2524.
  10. Efstathiou C, Abidi SH, Harker J, Stevenson NJ. Revisiting respiratory syncytial virus's interaction with host immunity, towards novel therapeutics. Cell. Mol. Life Sci. 2020;CMLS 77(24):5045–5058.
  11. Ouyang Y, Liao H, Hu Y, Luo K, Hu S, Zhu H. Innate Immune Evasion by Human Respiratory Syncytial Virus. Front. Microbiol. 2022;13:865592.
  12. Killikelly A, Tunis M, House A, Quach C, Vaudy W, Moore D. Overview of the respiratory syncytial virus vaccine candidate pipeline in Canada. Can. Commun. Dis. Rep. Releve Mal. Transm. Au Can. 2020;46(4):56–61.
  13. Díez-Domingo J, Sáez-Llorens X, Rodriguez-Weber MA, Epalza C, Chatterjee A, Chiu CH, et al. Safety and immunogenicity of a ChAd155-vectored respiratory syncytial virus (RSV) vaccine in healthy RSV-seropositive children 12–23 months of age. J. Infect. Dis. 2023;227(11):1293–1302.
  14. Cunningham CK, Karron R, Muresan P, McFarland EJ, Perlowski C, Libous J, et al. Live-attenuated respiratory syncytial virus vaccine with deletion of RNA synthesis regulatory protein M2-2 and cold passage mutations is overattenuated. Open Forum Infect. Dis. 2019;6(6)A:ofz212.
  15. Belshe RB, Van Voris, LP, Mufson MA. Parenteral administration of live respiratory syncytial virus vaccine: results of a field trial. J. Infect. Dis. 1982;145(3):311–319.
  16. Groothuis JR, King SJ, Hogerman DA, Paradiso PR, Simoes EA. Safety and immunogenicity of a purified F protein respiratory syncytial virus (PFP-2) vaccine in seropositive children with bronchopulmonary dysplasia. J. Infect. Dis. 19998;177(2): 467–469.
  17. Tristram DA, Welliver RC, Mohar CK, Hogerman DA, Hildreth SW, Paradiso P. Immunogenicity and safety of respiratory syncytial virus subunit vaccine in seropositive children 18–36 months old. J. Infect. Dis. 1993;167(1):191–195.
  18. Kim HW, Canchola JG, Brandt CD, Pyles G, Chanock RM, K Jensen, et al. Respiratory syncytial virus disease in infants despite prior administration of antigenic inactivated vaccine. Am. J. Epidemiol. 1969;89(4):422–434.
  19. Graham BS. Vaccine development for respiratory syncytial virus. Curr. Opin. Virol. 2017;23:107–112.
  20. Tang RS, Spaete RR, Thompson MW, MacPhail M, Guzzetta JM, Ryan PC, et al. Development of a PIV-vectored RSV vaccine: preclinical evaluation of safety, toxicity, and enhanced disease and initial clinical testing in healthy adults. Vaccine. 2008;26(50):6373–6382.
  21. Wright PF, Karron RA, Belshe RB, Shi JR, Randolph VB, Collins PL, et al. The absence of enhanced disease with wild type respiratory syncytial virus infection occurring after receipt of live, attenuated, respiratory syncytial virus vaccines. Vaccine. 2007; 25(42):7372–7378.
  22. Cunningham CK, Karron RA, Muresan P, Kelly MS, McFarland EJ, Perlowski C. Evaluation of recombinant live-attenuated respiratory syncytial virus (RSV) vaccines RSV/ΔNS2/Δ1313/I1314L and RSV/276 in RSV-seronegative children. J. Infect. Dis. 2022;226(12):2069–2078.
  23. McFarland EJ, Karron RA, Muresan P, Cunningham CK, Valentgine ME, Perlowski C, et al. Live-attenuated respiratory syncytial virus vaccine candidate with deletion of RNA synthesis regulatory protein M2-2 is highly immunogenic in children. J. Infect. Dis. 2018;217(9):13470–1355.
  24. McFarland, EJ, Karron RA, Muresan P, Cunningham CK, Perlowski C, Libous J, et al. Live-Attenuated respiratory syncytial virus vaccine with M2-2 deletion and with small hydrophobic noncoding region is highly immunogenic in children. J. Infect. Dis. 2020;221(12):2050–2059.
  25. Malkin E, Yogev R, Abughali N, Sliman J, Wang CK, Zuo F, et al. Safety and immunogenicity of a live attenuated RSV vaccine in healthy RSV-seronegative children 5 to 24 months of age. PloS One. 2013; 8(10):e77104.
  26. American Academy of Pediatrics Committee on Infectious Diseases & American Academy of Pediatrics Bronchiolitis Guidelines Committee. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics. 2014;134:e620–638.
  27. CDC Health Alert Network (HAN). Limited Availability of Nirsevimab in the United States—Interim CDC Recommendations to Protect Infants from Respiratory Syncytial Virus (RSV) during the 2023–2024 Respiratory Virus Season: https://www.cdc.gov/han/2023/han00499.html (2024).
  28. Sun, M, Lai H, Na F, Li S, Qiu X, Tian J, et al. Monoclonal antibody for the prevention of respiratory syncytial virus in infants and children: A systematic review and network meta-analysis. JAMA Netw. Open. 2023;6(2):e230023.
  29. Fernández P, Trenholme A, Abarca K, Griffin MP, Hultquist M, Harris B, et al. A phase 2, randomized, double-blind safety and pharmacokinetic assessment of respiratory syncytial virus (RSV) prophylaxis with motavizumab and palivizumab administered in the same season. BMC Pediatr. 2010;10:38.
  30. Munoz FM, Englund JA. Respiratory syncytial virus. Matern. Immun. 2019;213–234. doi: 10.1016/B978-0-12-814582-1.00011-5.
  31. Chu HY, Tielsch J, Katz J, Margaret AS, Khatry S, LeClerq SC, et al. Transplacental transfer of maternal respiratory syncytial virus (RSV) antibody and protection against RSV disease in infants in rural Nepal. J. Clin. Virol. Off. Publ. Pan Am. Soc. Clin. Virol. 2017;95:90–95.
  32. Glezen WP, Paredes A, Allison, JE, Taber LH, Frank AL. Risk of respiratory syncytial virus infection for infants from low-income families in relationship to age, sex, ethnic group, and maternal antibody level. J. Pediatr. 1981;98(5):708–715.
  33. Aranda SS, Polack FP. Prevention of pediatric respiratory syncytial virus lower respiratory tract illness: Perspectives for the next decade. Front. Immunol. 2019;10:1006.
  34. The American College of Obstetricians and Gynecologists. Should I get the RSV vaccine during pregnancy?: https://www.acog.org/womens-health/experts-and-stories/ask-acog/should-i-get-the-rsv-vaccine-during-pregnancy.
  35. American Medical Association. CDC guidelines for maternal RSV vaccine and latest FDA approvals with Sandra Fryhofer, MD: https://www.ama-assn.org/delivering-care/public-health/cdc-guidelines-maternal-rsv-vaccine-and-latest-fda-approvals-sandra.
  36. Simões EAF, Center KJ, Tita ATN, Swanson, KA, Radley D, Houghton J, et al. Prefusion F protein-based respiratory syncytial virus immunization in pregnancy. N Engl J Med. 2022;386:1615–1626.
  37. Palmeira P, Quinello C, Silveira-Lessa AL, Zago CA, Carneiro-Sampaio M. IgG placental transfer in healthy and pathological pregnancies. Clin. Dev. Immunol. 2012;2012:985646.
  38. Centers for Disease Control and Prevention. RSV vaccine guidance for pregnant people: https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/pregnant-people.html.
  39. Madhi SA, Polack FP, Piedra PA, Munoz FM, Trenholme AA, Simões EAF, et al. Respiratory syncytial virus vaccination during pregnancy and effects in infants. N. Engl. J. Med. 2020;383(5):426–439.
  40. Bebia Z, Reyes O, Jeanfreau R, Kantele A, Graciela De Leon R, Sánchez MG, et al. Safety and immunogenicity of an investigational respiratory syncytial virus vaccine (RSVPreF3) in mothers and their infants: A phase 2 randomized trial. J. Infect. Dis. 2023;228(3):299–310.
  41. Kampmann B, Madhi SA, Munjal I, Simões EAF, Pahud BA, Llapur C, et al. Bivalent prefusion F vaccine in pregnancy to prevent RSV illness in infants. N. Engl. J. Med. 2023;388(16): 1451–1464.
  42. Centers for Disease Control and Prevention. RSV (Respiratory Syncytial Virus) Immunizations: https://www.cdc.gov/vaccines/vpd/rsv/index.html (2024).
  43. Centers for Disease Control and Prevention. Vaccines for Children (VFC) Program: https://www.cdc.gov/vitalsigns/vaccines-for-children/index.html.
  44. Wodi AP. Advisory committee on immunization practices recommended immunization schedule for children and adolescents aged 18 years or younger — United States, 2024. MMWR Morb. Mortal. Wkly. Rep. 2024;73.
  45. Centers for Disease Control and Prevention. About the Vaccines for Children (VFC) Program: https://www.cdc.gov/vaccines-for-children/about/index.html.
  46. Wilcox CR, Calvert A, Metz J, Kilich E, MacLeod R, Beadon K, et al. Attitudes of pregnant women and healthcare professionals toward clinical trials and routine implementation of antenatal vaccination against respiratory syncytial virus: A multicenter questionnaire study. Pediatr. Infect. Dis. J. 2019;38(9):944–951.
  47. Kherfan T, Sallam M. Prospective attitudes towards respiratory syncytial virus (RSV) vaccination: Validation of a survey instrument among young females in Jordan pending vaccine authorization. Vaccines. 2023;11(8):1386.
  48. Limaye RJ, Sauer M, Njogu R, Singh P, Fesshaye B, Karron RA. Characterizing attitudes toward maternal RSV vaccines among pregnant and lactating persons in Kenya: Key considerations for demand generation efforts for vaccine acceptance. J. Pediatr. Infect. Dis. Soc. 2023;12(12):638–641.
DOI: https://doi.org/10.34763/jmotherandchild.20252901.d-25-00012 | Journal eISSN: 2719-535X | Journal ISSN: 2719-6488
Language: English
Page range: 93 - 100
Submitted on: Apr 15, 2025
Accepted on: May 28, 2025
Published on: Aug 16, 2025
Published by: Institute of Mother and Child
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2025 Ahila Ali, Laiba Shamim, Ahmed Ibrahim, Muhammad Abdullah Humayun, Muhammad Hamza Khan, Anum Akbar, Sanmit Jindal, Shahzaib Ahmed, Jamuna Shrestha, Muhammad Abdullah Nveed, published by Institute of Mother and Child
This work is licensed under the Creative Commons Attribution 4.0 License.