The Ongoing Debate: Universal Vaccination Strategies for Flu and RSV

Developing universal vaccination strategies for influenza (flu) and Respiratory Syncytial Virus (RSV) is a lot more complex and controversial than it sounds. There is an ongoing and multifaceted debate currently surrounding , comprising various arguments rooted in public health priorities, scientific challenges, economic considerations, societal impacts, and more. 

Both the flu and RSV are responsible for a significant amount of morbidity and mortality worldwide. Globally, an estimation of about 1 billion people are infected with the flu every year and RSV causes 33 million acute lower respiratory infections. Naturally, isolating a universal vaccination strategy for each disease would induce a very positive public health impact all across the globe. A universal flu vaccine could provide broad protection against various flu strains instead of the current seasonal flu vaccine which only protects you from the flu for the one winter season after you get the vaccine. Similarly, a universal vaccine for RSV, a leading cause of respiratory infections and a contributor to severe illness, would no doubt be transformative in preventing both severe illness and transmission of the virus. Not only could reaching the point of universal vaccination coverage reduce the amount of illness and death that occurs, but it could also perpetuate herd immunity and reduce the overall transmission of the flu and RSV in communities. This would benefit even those who couldn’t be vaccinated because there would be fewer disease carriers that could potentially catch the flu or RSV. Universal and widespread vaccination could also result in reducing healthcare costs because there would be fewer hospital and outpatient visits required, and the need for antiviral treatments would be diminished. The economic argument is especially appealing in light of the financial burden the flu and RSV place on healthcare systems. 

However, there are several scientific technological hurdles that you wouldn’t expect in developing these vaccinations. Establishing one universal flu vaccine is going to be particularly challenging because the virus changes and evolves very rapidly. As mentioned above, current vaccines are strain-specific and target the surface proteins of the virus. This complicates the development of a single, uniformly acting vaccine. There have been some approaches hatched trying to focus more on stable components of the virus–such as the nucleoprotein or M2 protein–but these are still in development. Additionally, while RSV vaccinations have made great strides there are still concerns about the drawbacks and immune effects, especially for young children. Previously, RSV vaccinations triggered some serious neurological disorders, namely Guillain-Barré syndrome (GBS), a rare autoimmune disease that affects the peripheral nervous system. Therefore neither vaccination is currently reliable or specific enough to be established worldwide–and even if promising universal vaccines were developed for either, their effectiveness would have to be closely monitored for some time. Ensuring high levels of efficacy, particularly for older adults and other high-risk groups is essential for a universal vaccine’s success. 

Despite there still being obvious risks and issues there have been a few significant advances recently in the development of these vaccinations. Several universal flu vaccine candidates are in various stages of development and some are beginning to show signs of promise, especially those that are being built on broadly neutralizing antibodies, which target more stable regions of the virus. Some of these candidates are starting to enter clinical trials and may offer protection for multiple years or at least across different flu strains. RSV vaccines are also making substantial progress, specifically in the realm of monoclonal antibody treatments: monoclonal antibodies (mAbs) are a type of targeted therapy that can be engineered to specifically recognize and neutralize harmful pathogens like RSV. In the case of RSV, these antibodies work by binding to the virus and blocking its ability to infect cells, essentially mimicking the natural immune response. This approach has proven productive in providing protection for high-risk populations, such as premature infants or older adults who are more vulnerable to severe RSV infections. Slowly but surely vaccination strategies for flu and RSV are being developed. The finalization of one universal vaccine for each disease will no doubt have a very positive medical impact: those who receive the vaccine will be interminably protected from infection, and those who can’t will have a significantly lower chance of contracting it. 

Bibliography: 

“Universal Influenza Vaccine Research | NIH: National Institute of Allergy and Infectious Diseases.” Nih.gov, 5 Sept. 2019, www.niaid.nih.gov/diseases-conditions/universal-influenza-vaccine-research.

News, P. V. M. “Cracking the Code on a Universal Flu Vaccine.” College of Veterinary Medicine, 8 Mar. 2024, vet.purdue.edu/news/cracking-the-code-on-a-universal-flu-vaccine.php.

Robinson, Erik. “Study Shows Promise for a Universal Flu Vaccine.” OHSU News, 19 July 2024, news.ohsu.edu/2024/07/19/study-shows-promise-for-a-universal-flu-vaccine.

Blanco, Jorge C. G., et al. “A Multifaceted Approach to RSV Vaccination.” Human Vaccines & Immunotherapeutics, vol. 14, no. 7, 19 June 2018, pp. 1734–1745, https://doi.org/10.1080/21645515.2018.1472183. Accessed 14 May 2020.