A COMPREHENSIVE new study has revealed that respiratory syncytial virus (RSV) hospitalisation rates among older adults in Europe are significantly underestimated, with serious implications for immunisation policy decisions.
With recent approvals of RSV vaccines for older adults, understanding the virus’s true burden has become increasingly urgent. To address this, researchers conducted a systematic review (PROSPERO CRD42024516945) combining published literature, surveillance data, and unpublished sources from international collaborators to estimate RSV-related hospitalisations in adults aged ≥60 years. Using statistical modelling, the team corrected for underdiagnosis due to varying diagnostic tests, specimen types, and case definitions. Where country-specific data were missing, an ensemble predictive model was employed to generate national estimates. The team also calculated in-hospital case fatality ratios for countries with available data.
The analysis incorporated data from 14 studies, including three unpublished. The adjusted RSV hospitalisation rates were found to be 2.2–6.4 times higher than previously reported unadjusted figures. Among the five countries with direct data, Denmark had the highest adjusted annual hospitalisation rate at 414 per 100,000 person-years (95% CI: 322–514), while the Netherlands and Finland recorded lower but still significant rates of 193 (125–304) and between 141–274 per 100,000, respectively. For 23 additional countries, the ensemble model predicted hospitalisation rates ranging from 223–317 per 100,000 person-years. RSV in-hospital case fatality ratios ranged widely, from 6.73% in Spain (4.63–9.69) to 10.14% in Switzerland (4.91–19.79).
This study provides robust, country-level RSV burden estimates for older adults across Europe, highlighting the urgent need to consider these figures when shaping national RSV immunisation strategies. Accurate burden assessments are vital to guide vaccine allocation and protect vulnerable older populations.
Reference
Zhang T et al; Respiratory Virus Global Epidemiology Network. Estimating the respiratory syncytial virus-associated hospitalisation burden in older adults in European countries: a systematic analysis. BMC Med. 2025;23(1):453.
