Table 1.

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

Abbreviation: RSV, respiratory syncytial virus.