Top 5 Takeaways

  1. Extensive Surveillance: The New Vaccine Surveillance Network (NVSN) conducted comprehensive surveillance of acute respiratory illnesses (ARIs) in children across the U.S. from 2016 to 2021.
  2. Major Viruses Identified: Rhinovirus/enterovirus (RV/EV) and respiratory syncytial virus (RSV) were the most frequently detected viruses.
  3. Pandemic Impact on Seasonality: There was a noticeable shift in the seasonality of respiratory viruses during the COVID-19 pandemic, with lower circulation from April 2020 to May 2021 and atypical RSV circulation in summer 2021.
  4. Demographics of Affected Children: A significant proportion of hospitalized children were infants under one year. The study reported racial and ethnic diversity among the participants.
  5. Importance of Ongoing Surveillance: Continued surveillance is crucial for understanding risk factors, health disparities, and guiding public health policies, especially in the context of emerging vaccines and therapeutics for viruses like SARS-CoV-2 and RSV.

Original Article Author and Citation

Corresponding Author

Ariana Perez,

Suggested Citation

Perez A, Lively JY, Curns A, et al. Respiratory Virus Surveillance Among Children with Acute Respiratory Illnesses — New Vaccine Surveillance Network, United States, 2016–2021. MMWR Morb Mortal Wkly Rep 2022;71:1253–1259. DOI:


The NVSN conducted active, population-based surveillance of pediatric ARIs at seven U.S. pediatric medical centers. The study focused on various respiratory viruses, including newly prevalent SARS-CoV-2, and involved collecting clinical data to assess risk factors and vaccine effectiveness.


Children with ARIs were enrolled across various healthcare settings. The study involved standardized interviews, medical chart reviews, and molecular testing of respiratory specimens for pathogens, including SARS-CoV-2, from December 2016 to August 2021.


Before the COVID-19 pandemic, detected viruses followed known seasonal trends, with peaks in late fall and winter. However, the pandemic led to uncharacteristic virus circulation, including lower levels of many respiratory viruses and atypical RSV patterns in 2021. The data highlighted the need for ongoing surveillance to adapt to changing virus circulation patterns and the impact of public health measures.


The NVSN’s extensive surveillance from 2016 to 2021 provides critical insights into the circulation of respiratory viruses among children, particularly during the disruptive period of the COVID-19 pandemic. This surveillance is fundamental in understanding pediatric respiratory illnesses and guiding public health interventions to protect children, especially in the context of emerging respiratory pathogens and vaccination strategies.


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