RSV is recognized as a cause of severe respiratory illness in older and at-risk adults, but reported incidence and prevalence rates vary widely between studies.

Our review of the published literature assessing RSV epidemiology in older adults identified lack of tailoring of the sampling period, failure to stratify results by age, limited sample size and absence of measures of uncertainty, as commonly reported limitations across studies.

Due to these limitations, a considerable proportion of studies are likely to underestimate the incidence of RSV infection in older adults; with several RSV vaccines currently under development and likely available already in 2023, this has the potential to underestimate the health benefit that can be gained from a vaccination program in older adults with RSV.

Well-designed studies and increased testing for RSV in patients with ARI are required to capture the clinical and economic burden of RSV and adequately inform vaccine policy in older adults.