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Schematic of DB1-QUAD live-attenuated RSV vaccine genome. DB1-QUAD includes codon deoptimization (gray shading) of NS1 and NS2 genes, deletion of the SH gene, replacement of the A2 F gene with a consensus sequence of the Buenos Aires (BA) F gene, and substitution of stabilizing line19F residues into the BAF sequence at positions 79, 191, 357, and 371.
