Developing Next-Generation Respiratory Virus Vaccines, Considerations

In an article published in Cell Host and Microbe, NIH researchers — including Anthony Fauci, David Morens, and Jeffery Taubenberger — discuss necessary considerations for scientists to develop the next generation of respiratory virus vaccines. The news release by the NIH notes that the viruses currently being researched for vaccination, such as influenza, respiratory syncytial virus (RSV), and SARS-CoV-2, have characteristics that make them more complicated than viruses like measles, mumps, and rubella, for which vaccines are available to provide long-term protection.

Some of these different features include a shorter incubation period, rapid transmission and replication in the nasal mucosa, and non-systemic reproduction. Based on these features and other factors, NIH researchers note that considerations should include vaccine antigen configuration, dose and adjunction, timing and route of vaccination, boosters, adjunctive treatments, and public health vaccination policies.

These viral infections — specifically the combined rise of COVID, RSV, and influenza infections, called the tripledemic — have resulted in many unfavorable clinical outcomes. RSV and influenza infections this season have been significantly higher than in previous years, with RSV being an average of 53% greater and influenza contributing to 74 deaths this year.

Causing shortages of hospital beds and medications and straining the pharmaceutical supply chain, the best way to ensure that the tripledemic causes minimal carnage is to encourage and advance vaccinations, improving existing technologies to create new ones. 

According to the NIH authors, additional research must be done on mucosa-replicating viruses before the next generation of vaccines can be delivered. Researchers note that future and ongoing studies should examine the interactions between these viruses. Additionally, research should investigate the immune response to viruses.

According to the NIH news release, the study states “that mucosal immunization appears to be an optimal route of vaccination for the viruses of interest, when feasible. However, to develop useful mucosal vaccines, significant knowledge gaps must be filled, including finding ideal vaccine formulations; determining dosage size, frequency, and timing; and developing techniques for overcoming immune tolerance.”

Overall, the authors urge researchers to acknowledge the many considerations surrounding mucosal viral infections. While these viral infections are complex and multifaceted, scientists must look for efficient and innovative ways to prevent and treat them, mitigating their resulting unfavorable outcomes.