Impaired Immune Response to Vaccination against Infection with Human Respiratory Syncytial Virus at Advanced Age

Elderly humans are prone to severe infection with human respiratory syncytial virus (HRSV). The aging of today’s human popu-lation warrants the development of protective vaccination strategies aimed specifically at the elderly. This may require special approaches due to deteriorating immune function. To design and test vaccination strategies tailored to the elderly population, we need to understand the host response to HRSV vaccination and infection at old age. Moreover, the preclinical need for testing of candidate vaccines requires translational models resembling susceptibility to the (unadapted) human pathogen. Here, we ex-plored the effects of aging on immunity and protection induced by a model HRSV vaccine candidate in a translational aging model in cotton rats (Sigmodon hispidus) and examined possibilities to optimize vaccination concepts for the elderly. We immu-nized young and aged cotton rats with a live-attenuated recombinant HRSV vaccine candidate and analyzed the induced im-mune response to and protection against challenge with HRSV. In old cotton rats, HRSV infection persisted longer, and vaccina-tion induced less protection against infection. Aged animals developed lower levels of vaccine-induced IgG, virus-neutralizing serum antibodies, and IgA in lungs. Moreover, booster responses to HRSV challenge were impaired in animals vaccinated at an older age. However, increased dose and reduced attenuation of vaccine improved protection even in old animals. This study shows that cotton rats provide a model for studying the effects of aging on the immune response to the human respiratory pathogen HRSV and possibilities to optimize vaccine concepts for the elderly