Abstract
Topic ImportanceSince its discovery in 1957, respiratory syncytial virus (RSV) has been widely recognized as a common and deadly pathogen. While early studies focused on the impact of RSV on the health of children, more recent data show that RSV imposes a significant burden on individuals aged 70 years or greater. RSV also substantially harms the health of individuals with cardiopulmonary diseases. Review FindingsEarly efforts to develop an RSV vaccine were hampered by toxicity due to antibody-enhanced viral pneumonia and a lack of efficacy in vaccines that targeted the post-fusion configuration of the F fusion protein, which is crucial to the pathogenesis of RSV-mediated injury. A newer wave of vaccines has targeted a stabilized prefusion F protein, generating effective neutralizing antibodies and reducing the burden of mild and severe RSV lower respiratory tract injury. This review focuses on the burden of RSV in patients with pulmonary diseases, highlights the tumultuous path from the early days of RSV vaccine development to the modern era, and offers insights into key gaps in knowledge that must be addressed in order to adequately protect the vulnerable population of patients with severe pulmonary diseases.
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