RSV disease in infants and young children: Can we see a brighter future?

Figures & data

Figure 1. Top 5 primary diagnoses in hospitalized infants <1 year of age in the USA.^3,36,49–51

Figure 2. Estimation of healthcare utilization related to RSV in children <2 year.^41,46,52

Figure 3. Schematic representation of RSV and RSV genome (Adapted from Tognarelli et al., 2019).⁶¹

Table 1. Main immunization approaches for RSV in infants and children.

mAbs	Maternal Vaccines	Pediatric Vaccines
Immunisation of infants at start of RSV season: Infants born in season immunized at birth Infants born before the season immunised at the start of the season Rapid and direct protection Duration at least 5 months (RSV season) with one injection	Vaccination of pregnant women in third trimester to protect neonates born in the RSV season through transplacental transfer of maternal antibodies Protection of neonate from birth Duration equivalent to the half-life of maternal antibodies (variable in the various studies between 21–27 days and 36–42 days) with actual efficacy waning after the first trimester of age.	Older infants and children vaccinated as part of a schedule, allowing time to develop an immune response Requires a mature immune system and time to mount an effective response Protection for one season and potentially beyond

Table

Protein	Function
M	Matrix protein. Non-glycosylated phosphorylated protein located external to the nucleocapsid layer, where it acts as a bridge between the lipid bilayer envelope and the nucleocapsid.
N	Nucleoprotein. Structural protein involved in the packaging of the viral RNA
P	Phosphoprotein. Interacts with L protein in the RNA replication.
L	RNA Polymerase. Replicates the viral RNA.
NS1/NS2	Non structural proteins. Involved in the evasion of the innate immune response
M2-1/M2-2	Regulatory proteins, involved in the regulation of the transcription and replication of the genome
SH	Small hydrophobic protein. Involved in the immune evasion (?)
G	Glycoprotein G, involved in: docking of the virion to the C×3C Chemochine Receptor 1 (CX3CR1) and glycosaminoglycans of the cell surface; inhibiting production of Interferon type I; promotion of Th-2 polarized response
F	Glycoprotein F, fusion protein, eliciting the fusion between the virion and the targeted cell, with resulting infection of the cytoplasm. Target protein: surface nucleolin

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