Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 May 12;13(5):510.
doi: 10.3390/vaccines13050510.

Addressing the Underestimated Burden of RSV in Older Adults in Europe: Epidemiology, Surveillance Gaps, and Public Health Implications

Floriana D'Ambrosio  1 , Marta Lomazzi  2   3 , Michael Moore  2 , Ada Maida  1 , Roberto Ricciardi  4 , Ludovica Munno  1 , Monia Lettieri  1 , Elisabetta De Vito  5 , Walter Ricciardi  1   2 , Giovanna Elisa Calabrò  4   5
Affiliations
Review

Addressing the Underestimated Burden of RSV in Older Adults in Europe: Epidemiology, Surveillance Gaps, and Public Health Implications

Floriana D'Ambrosio et al. Vaccines (Basel). .

Abstract

Background/objectives: Respiratory Syncytial Virus (RSV) is a leading cause of Lower Respiratory Tract Infections (LRTIs), posing a serious threat to vulnerable populations. Although growing evidence highlights its significant impact on older adults, RSV surveillance and data collection remain largely focused on children, underestimating the burden in older and high-risk adults. This review aims to synthesize current evidence on the epidemiological and clinical impact of RSV in older adults in Europe, assess existing surveillance strategies, and identify gaps to guide targeted public health responses.

Methods: A two-phase research strategy was adopted. First, a comprehensive review of studies published between 2015-2025 was conducted via PubMed, focusing on the RSV burden in high-risk and elderly populations in Europe. Second, a structured web screening was performed to assess the status of existing RSV surveillance systems, focusing on eight selected European countries.

Results: The review reported RSV prevalence rates ranging from 1% to 64.7% among older adults, with a high prevalence of comorbidities that exacerbate disease severity. Hospitalization rates varied between 12.6-55.9%, while mortality ranged from 2.15% to 13%, reaching up to 36% in intensive care settings. Surveillance systems for adult RSV infections across Europe remain limited and fragmented, with only 37.5% (3/8) of analyzed countries having dedicated surveillance for adults.

Conclusions: RSV represents a substantial and underrecognized threat to older adults, with significant clinical and healthcare implications. Strengthening surveillance, standardizing data collection, and ensuring equitable access to newly available preventive measures are urgent priorities to reduce the disease burden, protect vulnerable populations, and support resilient health systems against future health challenges.

Keywords: Europe; RSV vaccination; Respiratory syncytial virus; at-risk adults; elderly; epidemiology; surveillance systems.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest. The WFPHA has received an unrestricted grant from GSK for a broad project on RSV. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. GSK Biologicals SA was provided with the opportunity to review a preliminary version of the manuscript for factual accuracy. Authors are solely responsible for the content and interpretation.

Figures

Figure 1
Figure 1
Flow chart of PRISMA study [31].
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Blount R.E., Jr., Morris J.A., Savage R. Recovery of cytopathogenic agent from chimpanzees with goryza. Proc. Soc. Exp. Biol. Med. 1956;92:544–549. - PubMed
    1. Shi T., Denouel A., Tietjen A.K., Campbell I., Moran E., Li X., Campbell H., Demont C., Nyawanda B.O., Chu H.Y., et al. Global disease burden estimates of respiratory syncytial virus–associated acute respiratory infection in older adults in 2015: A systematic review and meta-analysis. J. Infect. Dis. 2020;222((Suppl. S7)):S577–S583. doi: 10.1093/infdis/jiz059. - DOI - PubMed
    1. Li Y., Hodgson D., Wang X., Atkins K.E., Feikin D.R., Nair H. Respiratory syncytial virus seasonality and prevention strategy planning for passive immunisation of infants in low-income and middle-income countries: A modelling study. Lancet Infect. Dis. 2021;21:1303–1312. doi: 10.1016/S1473-3099(20)30703-9. - DOI - PMC - PubMed
    1. Kim T., Choi S.H. Epidemiology and disease burden of respiratory syncytial virus infection in adults. Infect. Chemother. 2024;56:1. doi: 10.3947/ic.2024.0011. - DOI - PMC - PubMed
    1. Kaler J., Hussain A., Patel K., Hernandez T., Ray S. Respiratory syncytial virus: A comprehensive review of transmission, pathophysiology, and manifestation. Cureus. 2023;15:e36342. doi: 10.7759/cureus.36342. - DOI - PMC - PubMed

LinkOut - more resources