Respiratory syncytial virus (RSV) respiratory tract infections pose a significant global burden in young children and older adults. However, recent discoveries surrounding the neutralization-specific viral epitopes of the pre-fusion RSV glycoprotein have led to a shift in the design of RSV therapeutics from empirical to structure-based. Controlled human infection model studies have provided early-stage proof of concept for novel RSV monoclonal antibodies, vaccines, and antiviral drugs. The world’s first vaccines and first monoclonal antibody to prevent RSV among older adults and all infants, respectively, have recently been approved. However, the large-scale introduction of RSV prophylactics highlights the need for active surveillance to understand their global impact and to identify viral mutants that can escape novel prophylactics. This review provides an overview of RSV interventions in clinical development, including global disease burden, seasonality, pathogenesis, and host and viral factors related to RSV immunity.

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