TABLE 1.
Landscape of RSV Vaccines Undergoing Clinical Trials
| Vaccine Type | Viral Target | Adjuvanted | Target Population | Route of Administration | Clinical Development | Advantages | Disadvantages |
|---|---|---|---|---|---|---|---|
|
| |||||||
| Protein vaccines | |||||||
| Particle based | |||||||
| RSV F nanoparticle; (Novavax, Rockville, MD) | Post-F (prefusogenic) | AlPO4 or matrix M | Pediatrics*; elders†; maternal‡ |
Systemic | Phase-1*; phase-2†; phase-3‡ |
Safe Immunogenic | Post-F based Risk of ERD Ab durability |
| Subunit | |||||||
| DS-Cav1; (NIH) | Pre-F | Alum | Maternal, elders | Systemic | Phase-1 | Induce high-affinity neutralizing Ab | Factors affecting transplacental transfer |
| GSK RSV F§; (GlaxoSmith-Kline, Brentford, UK) | sPre-F | ±Al(OH)3 | Maternal, elders | Systemic | Phase-1 | Instability of pre-F§ Ab durability |
|
| DPX-RSV; (Immunovaccine, Nova Scotia, Canada and VIB) | SHe | Al(OH)3, lipid in oil | Elders | Systemic | Phase-1 | Facilitate crosspriming | No protection for premature infants |
| RSV-F (Janssen, Beerse, Belgium) | Pre-F | ND | Elders | Systemic | Phase-1 | ||
| RSV-F (Pfizer, New York, NY) | Pre-F | ND | Maternal, elders | Systemic | Phase-2 | ||
| RSV-G (Beijing Advaccine Biotech, Beijing, China) | G | ND | Pediatrics, elders | Systemic | Phase-1 | ||
| Live vaccines | |||||||
| Vector based | |||||||
| AdV26 RSV; (Janssen) | Pre-F | No | Pediatrics, elders | Systemic | Phase-2 | Not attenuated Low risk of ERD |
Potential for developing antivector immunity |
| ChAdV155-RSV; (GlaxoSmith-Kline) | Pre-F, N, M2–1 | No | Pediatrics | Systemic | Phase-2 | No interference with maternal Abs | |
| VXA-RSV (AdV5); (Vaxart, San Francisco, CA) | Post-F | dsRNA | Elders | Mucosal and systemic | Phase-1 | ||
| MVA-BN RSV; (Bavarian Nordic, Kvistgaard, Denmark) | Post-F, GA/GB, N, M2 | No | Elders | Systemic | Phase-2 | ||
| Live attenuated/chimeric | |||||||
| rBCG/N-hRSV; (Universidad de Chile) | N | No | Newborn | Systemic | Phase-1 | Predominant Th1 immune responses | |
| RSV/ΔG (Intravacc, Bilthoven, Netherlands) | Lacks G | No | Pediatric | Mucosal | Phase-1 | Low risk of ERD | Balance of attenuation/immunogenicity |
| RSV ΔNS2 Δ1313/1314L; RSV D46/NS2/N/ΔM2–2; RSV 6120/ΔNS2/1030S (Sanofi-Pasteur, Lyon, France and NIH) | RSV Pre/Post-F | No | Pediatric | Mucosal and systemic | Phase-1 | Intranasal delivery Replication in presence of maternal Ab |
Reverse to wild type Stability for mass production |
| SeV/RSV; (St Jude Hospital) | F | No | Pediatric | Mucosal | Phase-1 | Broad stimulation of immune responses | |
For VXA and MVA, it appears that expression of post-F > pre-F. ERD indicates: enhance RSV disease.
*
Phase-1 in Pediatrics.
†
Phase-2 in Elders.
‡
Phase-3 in Maternal.
§
Withdrawn.
Adv indicates adenovirus; Al(OH)3, aluminum hydroxide; AlPO4, aluminum phosphate; BN, Bavarian Nordic; ChAdV155, chimpanzee adenovirus 155; DPX, small cell epitope peptide vaccine; dsRNA, double stranded RNA; GSK, GlaxoSmith-Kline; MVA, modified vaccinia Ankara virus; ND, not disclosed; NIH, National Instutes of Health; rBCG/N-hRSV, recombinant bacillus of Calmette-Guérin/N-human RSV; s, soluble; Th, T-helper; VXA, Vaxart.