Table 1. Open in new tab Summary of...

Epidemiologic Gap

Summary

Surveillance for burden estimates

• Needed for all age groups, with finer age strata for extremes of age

• Include MAARI and hospitalizations

• Include high-risk populations, including preterm infants, children, and adults with underlying heart and lung disease, neurologic diseases, immunocompromised, Alaska Natives, American Indians, pregnant women, and residents of congregate settings (eg, long-term-care facilities)

• Ensure design of surveillance platforms:

-Can test for multiple respiratory pathogens

-Avoid influenza-like illness and severe acute respiratory infection definitions

RSV-associated mortality

• Collect hospital and community-associated RSV deaths in all age groups

Short- and long-term outcomes of RSV infection

• Investigate effects of RSV on recurrent wheezing and asthma, particularly long-term effects

• Conduct studies in pregnant women to determine impact of maternal RSV disease on pregnancy and neonatal outcomes

• Assess impact on frailty in older adults

Correlates of protection

• Assess durability of respiratory mucosal antibodies and role in protection

• Study correlation of neutralization and viral protein– or epitope-specific antibodies with disease protection

• Investigate role of cellular immunity in RSV disease outcome

Cost-effectiveness

• Costs and benefits of vaccine introduction in target populations, which will need up-to-date burden estimates, indirect and out-of-pocket costs associated with RSV- associated MAARI, hospitalizations, and deaths

Assessing RSV diagnostic practices

• Needed to document potential underestimation of disease burden due to testing behaviors

Surveillance once vaccine is introduced

• Adverse events

• Genomic sequencing of breakthrough infections to document changes in the virus

Table 1.

Open in new tab

Summary of Respiratory Syncytial Virus Epidemiologic Gaps

Epidemiologic Gap	Summary
Surveillance for burden estimates	• Needed for all age groups, with finer age strata for extremes of age
	• Include MAARI and hospitalizations
	• Include high-risk populations, including preterm infants, children, and adults with underlying heart and lung disease, neurologic diseases, immunocompromised, Alaska Natives, American Indians, pregnant women, and residents of congregate settings (eg, long-term-care facilities)
	• Ensure design of surveillance platforms:
	-Can test for multiple respiratory pathogens
	-Avoid influenza-like illness and severe acute respiratory infection definitions
RSV-associated mortality	• Collect hospital and community-associated RSV deaths in all age groups
Short- and long-term outcomes of RSV infection	• Investigate effects of RSV on recurrent wheezing and asthma, particularly long-term effects
	• Conduct studies in pregnant women to determine impact of maternal RSV disease on pregnancy and neonatal outcomes
	• Assess impact on frailty in older adults
Correlates of protection	• Assess durability of respiratory mucosal antibodies and role in protection
	• Study correlation of neutralization and viral protein– or epitope-specific antibodies with disease protection
	• Investigate role of cellular immunity in RSV disease outcome
Cost-effectiveness	• Costs and benefits of vaccine introduction in target populations, which will need up-to-date burden estimates, indirect and out-of-pocket costs associated with RSV- associated MAARI, hospitalizations, and deaths
Assessing RSV diagnostic practices	• Needed to document potential underestimation of disease burden due to testing behaviors
Surveillance once vaccine is introduced	• Adverse events
Surveillance once vaccine is introduced	• Genomic sequencing of breakthrough infections to document changes in the virus

Epidemiologic Gap	Summary
Surveillance for burden estimates	• Needed for all age groups, with finer age strata for extremes of age
	• Include MAARI and hospitalizations
	• Include high-risk populations, including preterm infants, children, and adults with underlying heart and lung disease, neurologic diseases, immunocompromised, Alaska Natives, American Indians, pregnant women, and residents of congregate settings (eg, long-term-care facilities)
	• Ensure design of surveillance platforms:
	-Can test for multiple respiratory pathogens
	-Avoid influenza-like illness and severe acute respiratory infection definitions
RSV-associated mortality	• Collect hospital and community-associated RSV deaths in all age groups
Short- and long-term outcomes of RSV infection	• Investigate effects of RSV on recurrent wheezing and asthma, particularly long-term effects
	• Conduct studies in pregnant women to determine impact of maternal RSV disease on pregnancy and neonatal outcomes
	• Assess impact on frailty in older adults
Correlates of protection	• Assess durability of respiratory mucosal antibodies and role in protection
	• Study correlation of neutralization and viral protein– or epitope-specific antibodies with disease protection
	• Investigate role of cellular immunity in RSV disease outcome
Cost-effectiveness	• Costs and benefits of vaccine introduction in target populations, which will need up-to-date burden estimates, indirect and out-of-pocket costs associated with RSV- associated MAARI, hospitalizations, and deaths
Assessing RSV diagnostic practices	• Needed to document potential underestimation of disease burden due to testing behaviors
Surveillance once vaccine is introduced	• Adverse events
Surveillance once vaccine is introduced	• Genomic sequencing of breakthrough infections to document changes in the virus

Abbreviation: RSV, respiratory syncytial virus.

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