Abstract
In 1966, infants and children in the USA were immunized with a formalin-inactivated vaccine against respiratory syncytial virus. The vaccine was immunogenic but elicited mainly nonprotective antibody. Upon exposure to respiratory syncytial virus in the community, immunized children developed severe pulmonary disease characterized by bronchoconstriction and pneumonia. Two immunized infants died as toddlers after respiratory syncytial virus infection. Exploration of the mechanisms of disease has dominated the literature for decades. In this review, the pathogenesis of enhanced respiratory disease is discussed and the characteristics of protective and pathogenic respiratory syncytial virus vaccines are examined.
Publication types
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Historical Article
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Research Support, U.S. Gov't, P.H.S.
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Review
MeSH terms
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Animals
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Antibody Formation*
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Bronchopneumonia / etiology
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Bronchopneumonia / immunology
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Complement Activation
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Disease Models, Animal
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Formaldehyde
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History, 20th Century
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Humans
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Immunity, Cellular
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Infant
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Pulmonary Eosinophilia / etiology
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Pulmonary Eosinophilia / immunology
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Respiratory Syncytial Virus Infections / etiology
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Respiratory Syncytial Virus Infections / immunology*
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Respiratory Syncytial Virus Infections / prevention & control
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Respiratory Syncytial Virus Vaccines / adverse effects*
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Respiratory Syncytial Virus Vaccines / history
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Respiratory Syncytial Virus, Human / immunology*
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Th2 Cells / immunology
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Vaccination / adverse effects*
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Vaccines, Inactivated / adverse effects
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Viral Envelope Proteins / immunology
Substances
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Respiratory Syncytial Virus Vaccines
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Vaccines, Inactivated
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Viral Envelope Proteins
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attachment protein G
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Formaldehyde