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<p>Respiratory syncytial virus (RSV) cocirculates as two antigenic subgroups, RSV A and RSV B, with irregular dominance by season. Despite highly conserved fusion (F) protein epitopes, sequence, and antigenic differences between A and B, especially within prefusion F, can modulate neutralization and susceptibility. First-in-class adult RSV vaccines licensed in 2023 adopt two antigen strategies: monovalent stabilized prefusion F based on sequences from the RSV A subgroup, and bivalent stabilized prefusion F antigens from both RSV A and RSV B subgroups to decrease reliance on RSV A cross-protection. Clinical data from bivalent vaccine studies support high efficacy against disease from both subgroups, while monovalent vaccine studies suggest that RSV B cross-protection may wane more quickly. Emerging and continued real-world vaccine effectiveness monitoring of both monovalent and bivalent RSV vaccines will be needed to assess this early signal.</p>

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Adult RSV Vaccination: What Is the Role of RSV Subgroup in Disease Prevention?

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月5日

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  • S. Elizabeth Williams,
  • Giovanni Checcucci Lisi,
  • Kate Luisi,
  • Kumar Ilangovan,
  • Cassandra Hall-Murray,
  • Kyla Hayford,
  • Elizabeth Begier

摘要

Respiratory syncytial virus (RSV) cocirculates as two antigenic subgroups, RSV A and RSV B, with irregular dominance by season. Despite highly conserved fusion (F) protein epitopes, sequence, and antigenic differences between A and B, especially within prefusion F, can modulate neutralization and susceptibility. First-in-class adult RSV vaccines licensed in 2023 adopt two antigen strategies: monovalent stabilized prefusion F based on sequences from the RSV A subgroup, and bivalent stabilized prefusion F antigens from both RSV A and RSV B subgroups to decrease reliance on RSV A cross-protection. Clinical data from bivalent vaccine studies support high efficacy against disease from both subgroups, while monovalent vaccine studies suggest that RSV B cross-protection may wane more quickly. Emerging and continued real-world vaccine effectiveness monitoring of both monovalent and bivalent RSV vaccines will be needed to assess this early signal.