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Vol. 24. Issue 2.
Pages 150-157 (April - June 2023)
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Vol. 24. Issue 2.
Pages 150-157 (April - June 2023)
Review article
Current situation and future perspectives of vaccines against respiratory syncytial virus
Situación actual y perspectivas de futuro de las vacunas frente al virus respiratorio sincitial
Jordi Reina
Corresponding author
jorge.reina@ssib.es

Corresponding author.
, Elisa Gónzalez de Herrero
Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Espases, Facultad de Medicina de la Universitat Illes Balears, Palma de Mallorca, Spain
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Table 1. Main vaccines under development against respiratory syncytial virus in the paediatric population.
Table 2. Main vaccines under development against respiratory syncytial virus in the pregnant population.
Table 3. Major respiratory syncytial virus vaccines in development in the adult population.
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Abstract

The Respiratory Syncytial Virus (RSV) is the cause of acute respiratory pathologies (bronchiolitis and pneumonia) that occurs preferably as epidemic in the winter months. RSV is a good vaccine candidate since as a virus it has shown genetic and antigenic stability, most infections are self-limited and the only natural reservoir is humans. According to epidemiological data, there are three target populations that require different approaches for the RSV vaccine: naive children <4–6 months, children >6 months, and >65 years. Multiple vaccine platforms based on the preF protein are currently being studied, although the use of long-lived monoclonal antibodies must be considered in the first year of life. In the child population, beyond this period, attenuated vaccines probably play a relevant role, since they expose the complete viral particle to the immune system and induce a broad-spectrum neutralising antibody response. In the population > 65 years of age, the need to use a subunit vaccine with an adjuvant that stimulates the immune response or mRNA vaccines is evident. The future in the prevention of RSV infection and disease in the human population will be based on the use of monoclonal antibodies and vaccines adapted to each age group.

Keywords:
Respiratory Syncytial Virus
Vaccines
Risk groups
Resumen

El Vvirus respiratorio sincitial (VRS) es el causante de patologías respiratorias agudas (bronquiolitis y neumonías) que se presenta preferentemente de forma epidémica en los meses invernales. El VRS es un buen candidato vacunal ya que como virus ha mostrado una estabilidad genética y antigénica, la mayoría de las infecciones son autolimitadas y el único reservorio natural es el ser humano. De acuerdo con los datos epidemiológicos existen tres poblaciones diana que requieren de aproximaciones diferentes para la vacuna frente al VRS: los niños naive de <4–6 meses, los niños >6 meses y los >65 años. En estos momentos se están estudiando múltiples plataformas vacunales, basadas en la proteína preF, aunque hay que considerar la utilización de los anticuerpos monoclonales de vida prolongada en el primer año de vida. En la población infantil, mas allá de este período, probablemente las vacunas atenuadas tengan un papel relevante, ya que exponen al sistema inmune la partícula vírica completa e inducen una respuesta de anticuerpos neutralizantes de amplio espectro. En la población de >65 años, es evidente la necesidad de utilizar una vacuna de subunidades con un adyuvante que estimule la respuesta inmune o las vacunas de ARNm. El futuro en la prevención de la infección y enfermedad por VRS en la población humana, se basará en la utilización de anticuerpos monoclonales y vacunadas adaptadas a cada grupo de edad.

Palabras clave:
Virus respiratorio sincitial
Vacunas
Grupos de riesgo

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