Fatal Enhanced Respiratory Syncytial Virus Disease in Toddlers

Overview

Journal Sci Transl Med

Specialties General Medicine
Science

Date 2021 Oct 20

PMID 34669442

Citations 14

Authors

Fernando P Polack

Damian Alvarez-Paggi

Romina Libster

Mauricio T Caballero

Robert V Blair

Diego R Hijano

Paola X De la Iglesia Niveyro

Daniel R Menendez

Wes Gladwell

Luis M Avendano

Luis Velozo

Alanna Wanek

Eduardo Bergel

Gregory A Prince

Steven R Kleeberger

Joyce Johnson

Derek Pociask

Jay K Kolls

Affiliations

Soon will be listed here.

Abstract

In 1967, two toddlers immunized with a formalin-inactivated vaccine against respiratory syncytial virus (FIRSV) in the United States died from enhanced RSV disease (ERD), a severe form of illness resulting from aberrant priming of the antiviral immune response during vaccination. Up to 80% of immunized children subsequently exposed to wild-type virus were hospitalized. These events hampered RSV vaccine development for decades. Here, we provide a characterization of the clinical, immunopathological, and transcriptional signature of fatal human ERD, outlining evidence for safety evaluation of RSV vaccines and a framework for understanding disease enhancement for pathogens in general.

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Recombinant RSV G protein vaccine induces enhanced respiratory disease via IL-13 and mucin overproduction.

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