In 1967, two toddlers immunized with a formalin-inactivated vaccine against respiratory syncytial virus (FIRSV) in the United States died from enhanced RSV disease (ERD), a severe form of illness resulting from aberrant priming of the antiviral immune response during vaccination. Up to 80% of immunized children subsequently exposed to wild-type virus were hospitalized. These events hampered RSV vaccine development for decades. Here, we provide a characterization of the clinical, immunopathological, and transcriptional signature of fatal human ERD, outlining evidence for safety evaluation of RSV vaccines and a framework for understanding disease enhancement for pathogens in general.

中文翻译：

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幼儿致命的增强型呼吸道合胞病毒病


1967 年，美国两名接种福尔马林灭活呼吸道合胞病毒 (FIRSV) 疫苗的幼儿死于增强型 RSV 病 (ERD)，这是一种由于疫苗接种过程中抗病毒免疫反应异常引发而导致的严重疾病。随后接触野生型病毒的免疫儿童中，高达 80% 被送往医院。这些事件阻碍了 RSV 疫苗的开发数十年。在这里，我们提供了致命性人类 ERD 的临床、免疫病理学和转录特征的表征，概述了 RSV 疫苗安全性评估的证据，以及了解一般病原体疾病增强的框架。