Immunological goals for respiratory syncytial virus vaccine development

•Immunological goals for vaccination depend on whether it is for primary induction or boosting of pre-existing immunity.•Boosting neutralizing activity is the major goal for maternal and elderly populations.•High potency neutralizing activity is primarily directed to the RSV F glycoprotein and is conformation-dependent.•For antigen-naïve infants, avoidance of immunopathology is as important as induction of protective immunity.•New technologies have informed precision vaccine design and yielded new interventions to reduce the burden of RSV disease.