{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:06:53Z","timestamp":1790791613222,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Understanding hospitalisation burden of respiratory syncytial virus (RSV)\u2013associated acute respiratory infection (ARI) in adults is crucial for informing immunisation policy, yet such data are lacking in most high\u2010income countries. We aimed to estimate country\u2010level RSV\u2010associated ARI hospitalisation rates among adults aged 18\u201364 and \u2265\u200965\u2009years across high\u2010income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data on adult RSV hospitalisation burden were identified from systematic literature review and national surveillance reports. A Bayesian adjustment was applied to account for underascertainment due to variability in diagnostic methods and clinical specimens. An ensemble modelling framework consisting of four independent approaches was developed to predict country\u2010level RSV\u2010associated ARI hospitalisation rates among adults aged 18\u201364 and \u2265\u200965\u2009years across 63 high\u2010income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The ensemble model predicted a median annual RSV\u2010associated ARI hospitalisation rate of 39 per 100,000 (interquartile range [IQR]: 33\u201348) for adults aged 18\u201364\u2009years and 374 per 100,000 (318\u2013468) for those aged \u2265\u200965\u2009years across the 63 countries. The predicted rates varied substantially by continent; Africa (Seychelles) had the lowest RSV hospitalisation rate for both 18\u201364 and \u2265\u200965\u2009years (17 and 188 per 100,000, respectively); the highest median RSV hospitalisation rate was in Oceania in adults aged 18\u201364\u2009years (50 per 100,000; IQR: 31\u201351) and was in the Americas in adults aged \u2265\u200965\u2009years (455 per 100,000; 428\u2013518). Europe and Asia showed marked within\u2010continent variations in RSV hospitalisation rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although primary RSV disease burden data remain the gold standard for evidence\u2010based vaccine policy development, this study offers a viable alternative reference for high\u2010income countries lacking such data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.70291","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T01:47:45Z","timestamp":1783648065000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Country\u2010Level RSV\u2010Related Hospitalisation Rates Among Adults in High\u2010Income Countries From an Ensemble Model Based on Direct Viral Testing Incidence Data"],"prefix":"10.1111","volume":"20","author":[{"given":"Shuyu","family":"Deng","sequence":"first","affiliation":[{"name":"Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health Nanjing Medical University  Nanjing China"},{"name":"Key Laboratory of Public Health Safety and Emergency Prevention and Control Technology of Higher Education Institutions in Jiangsu Province Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiantian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health Nanjing Medical University  Nanjing China"},{"name":"Key Laboratory of Public Health Safety and Emergency Prevention and Control Technology of Higher Education Institutions in Jiangsu Province Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihua","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health Nanjing Medical University  Nanjing China"},{"name":"Key Laboratory of Public Health Safety and Emergency Prevention and Control Technology of Higher Education Institutions in Jiangsu Province Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Begier","sequence":"additional","affiliation":[{"name":"Global Medical Development Scientific and Clinical Affairs Pfizer Vaccines  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8375-631X","authenticated-orcid":false,"given":"Caihua","family":"Liang","sequence":"additional","affiliation":[{"name":"Global Vaccines Pfizer Inc  Collegeville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiko","family":"Sato","sequence":"additional","affiliation":[{"name":"HTA Value &amp; Evidence Pfizer Inc  Collegeville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5536-080X","authenticated-orcid":false,"given":"Sebastien","family":"Kenmoe","sequence":"additional","affiliation":[{"name":"Centre for Global Health, Usher Institute University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradford D.","family":"Gessner","sequence":"additional","affiliation":[{"name":"Global Vaccines Pfizer Inc  Collegeville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9432-9100","authenticated-orcid":false,"given":"Harish","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health Nanjing Medical University  Nanjing China"},{"name":"Centre for Global Health, Usher Institute University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health Nanjing Medical University  Nanjing China"},{"name":"Key Laboratory of Public Health Safety and Emergency Prevention and Control Technology of Higher Education Institutions in Jiangsu Province Nanjing Medical University  Nanjing China"},{"name":"Centre for Global Health, Usher Institute University of Edinburgh  Edinburgh UK"},{"name":"Changzhou Third People's Hospital, Changzhou Medical Center Nanjing Medical University  Changzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00478-0"},{"issue":"7","key":"e_1_2_10_3_1","first-page":"S577","article-title":"Global Disease Burden Estimates of Respiratory Syncytial Virus\u2010Associated Acute Respiratory Infection in Older Adults in 2015: A Systematic Review and Meta\u2010Analysis","volume":"222","author":"Shi T.","year":"2015","journal-title":"Journal of Infectious Diseases"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-023-00758-5"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad012"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(24)00455-9"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000001000"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.13031"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-023-00792-3"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofag341"},{"key":"e_1_2_10_11_1","unstructured":"JBI \u201cCritical Appraisal Tools \u201d (2025) https:\/\/jbi.global\/critical\u2010appraisal\u2010tools."},{"issue":"1","key":"e_1_2_10_12_1","first-page":"69","article-title":"Influenza Collaborators Mortality, Morbidity, and Hospitalisations due to Influenza Lower Respiratory Tract Infections, 2017: An Analysis for the Global Burden of Disease Study 2017","volume":"7","author":"GBD","year":"2017","journal-title":"Lancet. Respiratory Medicine"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaf204"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/86.4.948"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-025-04249-x"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac300"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12914"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab595"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad315"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104347"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234235"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae184"},{"issue":"10","key":"e_1_2_10_23_1","article-title":"Hospitalisation due to Respiratory Syncytial Virus in a Population\u2010Based Cohort of Older Adults in Spain, 2016\/17 to 2019\/20","volume":"30","author":"Vera\u2010Punzano N.","year":"2025","journal-title":"Euro Surveillance"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis309"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12234"},{"issue":"25","key":"e_1_2_10_26_1","article-title":"Hospitalisation Trends of Respiratory Syncytial Virus (RSV) Infection in Adults, Six European Countries, Before and During COVID\u201019, 2016 to 2023","volume":"30","author":"Urchuegu\u00eda\u2010Fornes A.","year":"2025","journal-title":"Euro Surveillance: Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1125-z"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043951"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.4.499"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2017.09.001"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1017\/S095026881900195X"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-024-01018-w"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2025.106440"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.70092"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103292"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-024-00920-7"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-024-01041-x"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-024-00951-0"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0344294"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.09.020421"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61204-6"}],"container-title":["Influenza and Other Respiratory Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.70291","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/irv.70291","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.70291","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:39:57Z","timestamp":1786541997000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/irv.70291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":40,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/irv.70291"],"URL":"https:\/\/doi.org\/10.1111\/irv.70291","archive":["Portico"],"relation":{},"ISSN":["1750-2640","1750-2659"],"issn-type":[{"value":"1750-2640","type":"print"},{"value":"1750-2659","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70291"}}