A decade of maternal RSV vaccine trials: what remains unresolved and why it matters

“A lot of work is still needed to prioritize which vaccines pregnant women should receive, which will differ depending on region and disease burden.”Ashling Cannon, Editor, Vaccine Insights , speaks with Shabir Madhi, Dean of the Faculty of Health Sciences and Director, South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit (Wits VIDA), University of the Witwatersrand) about the questions a decade of maternal respiratory syncytial virus (RSV) vaccine trials has raised but not resolved: why efficacy diverges markedly between trial sites, what the unexplained preterm birth signal that led to early termination of the GSK maternal RSV program means for the field, and why no validated correlate of protection for infant RSV disease has yet been established. Madhi also addresses the design of the RSV_IMPACT study, which is powered to investigate both the prematurity signal and the correlate question, the ALIVE program’s progress in building vaccinology research capacity across Africa, and why combination vaccines represent the single systemic advance that would most accelerate maternal immunization uptake over the next decade.