![]() In the 1960s, encouraged by recent successes in the development of other vaccines, researchers tried creating a vaccine for RSV, giving formalin-inactivated RSV to infants who had never had RSV before. Scientists first isolated RSV from chimpanzees back in 1956, but later studies showed that most humans already had antibodies against the virus, suggesting it had been around for a long time. James Campbell, a pediatric infectious disease specialist at the University of Maryland School of Medicine who has run trials on RSV vaccines with industry partners, says: “It’s such a bad disease for young children that if we have a way of protecting them, all pediatricians and parents are going to want to have that option.” From failures to a structure-based vaccine Pediatricians’ offices have started to test for RSV along with the flu and COVID-19. The news is particularly relevant after this past winter’s severe RSV season, as the virus surged in older adults, and children’s hospital wards have filled up with RSV-afflicted kids. On February 28th and March 1st, the FDA will convene an Advisory Committee meeting to discuss the safety and effectiveness of two of these vaccines in older adults. Just 14 years after McLellan (then a fellow in Peter Kwong’s NIAID lab) and Graham first began working together, a deluge of clinical trials based on their findings is yielding promising results for vaccines against RSV. Everybody knows meningitis, everybody knows pneumonia, everybody knows urinary tract infections, but RSV is really a big unknown” to the public, says Bont. Despite this, RSV is a virus that has historically received little public attention. In lower-income and middle-income countries that lack access to oxygen and ventilators, RSV is the second leading cause of infant mortality after the neonatal period, following malaria. “In the winter season, if you go to the intensive care unit, you would probably see that more than half of all the children are mechanically ventilated for RSV infection,” says Louis Bont, a pediatric infectious disease specialist at University Medical Center Utrecht in The Netherlands, who specializes in RSV and who advises several companies working on RSV vaccines. Meanwhile, one in 50 infants in the US-most of them full-term, healthy kids-are hospitalized for RSV each year. More than 60,000 hospitalizations for RSV occur each year among US adults 65 and older, with upwards of 6,000 deaths. RSV infection resembles a cold in older kids and adults, but can be far more serious in people who are much younger or older. Visualizing that protein conformation was a leap forward on the path.Īn effective immunization for RSV, a virus that had thwarted vaccine development attempts for 60 years, could save lives and protect lung health for millions around the world. Earlier research had suggested that if they could stabilize one particular conformation-the so-called pre-fusion form-of the F protein, which RSV uses to enter human cells, they might be able to use it as an effective vaccine, says Graham, who has now recently retired after more than 20 years at the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases (NIAID) and has joined Morehouse School of Medicine. At the end of November 2012, Graham recounts, they could see the crystallized respiratory syncytial virus (RSV) F protein at atomic resolution using X-ray diffraction. Jason McLellan and Barney Graham knew they had it. ![]() ABOVE: MODIFIED FROM © ISTOCK.COM, MICROVONE
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