If you already use build process, the additional step would be just one additional step in the build process, "invisible" to you. So "save in Vi, reload" still works.
If you don't have build process when writing JS code for browser, well... I don't know how it's possible.
I suggest you to look at browserify (http://browserify.org). For sweet.js there's sweetify (https://npmjs.org/package/sweetify) transform.
Note, that sweet.js compiler generates source maps, so you can debug your code with comfort.
Syntax highlighting still works, because most of the syntax highlighters highlight tokens and macros preserve token structure of the language (well it can kinda "introduce" keywords, but if you use Vi, it's just 1 line of code to fix your setup).