During the winter months, peadiatric hospital departments across Europe often face intense pressure, with hospital beds reaching full capacity. Seasonal infectious diseases such as respiratory syncytial virus (RSV), influenza, and COVID-19 spread easily among young children, whose immune systems are still developing, making them more vulnerable to severe illness. Despite the significant burden these viruses impose, most European countries have yet to introduce routine immunisation programs for children against these pathogens1. For instance, while the United Kingdom has implemented a universal influenza vaccination program for children, many other European nations do not recommend influenza vaccination for healthy children yet2. Something similar applies to RSV. After the initial (sporadic) use of the antibody Synagis, which is not used very often in clinical practice. 3 More recently, the European Medicines Agency approved two new RSV-disease prevention therapies, the RSV monoclonal antibody nirsevimab (Beyfortus) in 20224, and a maternal RSV vaccine (Abrysvo) in 20235. However, their adoption into national immunisation schedules remains limited6. This lack of widespread peadiatric vaccination contributes to the rapid escalation of outbreaks among children.
The surge in peadiatric infectious diseases during these months places significant strain on hospital systems that are primarily designed to handle average patient volumes rather than seasonal peaks. In Belgium, for instance, respiratory syncytial virus (RSV) infections account for 20%–40% of occupied peadiatric beds during peak periods (November–December), with 46 hospital sites experiencing daily occupancy rates exceeding 100% for a median of nine days7. Similarly, in the Netherlands, all peadiatric intensive care units reached full capacity during a recent RSV and influenza epidemic, leading to the postponement of scheduled surgeries and the transfer of patients to other facilities8. Germany faced a comparable crisis, with a survey revealing that half of the clinics had to turn away children for peadiatric intensive care due to a lack of available beds and staff shortages9. In the UK, several hospitals declared critical incidents as they struggled to cope with the influx of peadiatric patients suffering from respiratory illnesses, urging the public to seek alternative care options for non-urgent issues10.
These capacity challenges are further compounded by financial pressures. The cost of care escalates during peak times due to factors such as the need for additional staff and extended use of medical resources. A nationwide prospective study in the Netherlands estimated that RSV-related paediatric intensive care unit (PICU) admissions cost between €3.1 million and €3.8 million per season. The median cost per patient was €14,356.85, with higher costs observed in infants under three months of age and those born prematurely. The study also projected that implementing RSV preventive interventions could avert €1.9 to €2.6 million in PICU-related healthcare costs per season, depending on factors like vaccine efficacy and uptake11. These financial strains can impact
Ongoing research will be key to understanding and managing the burden of peadiatric infectious diseases more effectively. It can help quantify the true disease burden and healthcare strains, support more predictable resource planning, and identify patient subgroups that may benefit most from targeted interventions. However, because this research involves minors, it is inherently more complex than studies involving adult patients. This is particularly true for clinical trials, where there are additional requirements such as parental consent, age-specific endpoints, and specialised clinical infrastructure12. Even retrospective cohort studies, which rely on existing clinical data and are generally more feasible, come with unique hurdles in peadiatric populations—such as fragmented data, inconsistent outcome reporting, and stricter data governance13. Nevertheless, generating robust evidence in this field is essential to improve both care delivery and policy decisions for children.
At LOGEX, we are removing barriers to international peadiatric infectious disease research through our real-world data RTI Observatory — a growing, cross-border infrastructure linking longitudinal clinical, cost, and claims data across more than 20 hospitals in Europe. Both peadiatric and adult cohorts are included in a secure and compliant way, enabling insights into real-world care pathways and outcomes across age groups. Our proven ability to standardise fragmented, non-harmonised real-world data makes it possible to generate actionable insights, even in complex settings. Reach out to us if you are interested in learning more about joining or sponsoring the RTI Observatory.
1 European Centre for Disease Prevention and Control. (2023). Immunisation schedules by antigen (children). https://vaccination-schedules.ecdc.europa.eu/
2 European Centre for Disease Prevention and Control. (2019). Seasonal influenza vaccination and antiviral use in EU/EEA Member States – Overview of vaccination recommendations and coverage rates in the 2017–2018 and 2018–2019 influenza seasons. https://www.ecdc.europa.eu/en/publications-data/seasonal-influenza-vaccination-antiviral-use-eu-eea-member-states
3 European Medicines Agency. (1999). Synagis : EPAR - Product Information. https://www.ema.europa.eu/en/medicines/human/EPAR/synagis
4 European Medicines Agency. (2022). Beyfortus: EPAR – Product information. https://www.ema.europa.eu/en/medicines/human/EPAR/beyfortus
5 European Medicines Agency. (2022). Abrysvo: EPAR – Product information. https://www.ema.europa.eu/en/medicines/human/EPAR/abrysvo
6 Martínez, A., De Luca, M., & Sørensen, H. (2024). Real-world implementation of RSV immunization: Lessons from European health systems. Discover Health Systems, 3(1), Article 198. https://doi.org/10.1007/s44250-025-00198-7
7 Lagrou, K., Cools, F., Allegaert, K., Bael, A., Van de Voorde, P., Verhulst, S. L., ... & Desmet, S. (2023). RSV burden and its impact on pediatric inpatient care in Belgium: A retrospective national study. The Pediatric Infectious Disease Journal, 42(10). https://journals.lww.com/pidj/abstract/2023/10000/rsv_burden_and_its_impact_on_pediatric_inpatient.5.aspx
8 Linssen RS, Bem RA, Kapitein B, Rengerink KO, Otten MH, den Hollander B, Bont L, van Woensel JBM; PICE Study Group. Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units. Eur J Pediatr. 2021 Oct;180(10):3141-3149. doi: 10.1007/s00431-021-04079-y. Epub 2021 Apr 23. PMID: 33891158; PMCID: PMC8429147.
9 Wick M, Poshtiban A, Kramer R, Bangert M, Lange M, Wetzke M, Damm O. Inpatient burden of respiratory syncytial virus in children ≤2 years of age in Germany: A retrospective analysis of nationwide hospitalization data, 2019-2022. Influenza Other Respir Viruses. 2023 Nov;17(11):e13211.
10 Taylor S, Taylor RJ, Lustig RL, et alModelling estimates of the burden of respiratory syncytial virus infection in children in the UKBMJ Open 2016;6:e009337.
11 Benschop, K. S. M., van Sommeren, M., Veldhuijzen, I. K., Reukers, D. F. M., Westerhof, L. P. J. M., van Gageldonk-Lafeber, A. B., Teirlinck, A. C., & van den Dungen, F. A. M. (2024). Paediatric intensive care burden of RSV in the Netherlands: A prospective nationwide study and modelled impact of immunisation. The Lancet Regional Health – Europe, 38, 100829. https://doi.org/10.1016/j.lanepe.2024.100829
12 Caldwell, P. H., Murphy, S. B., Butow, P. N., & Craig, J. C. (2004). Clinical trials in children. The Lancet, 364(9436), 803–811. https://doi.org/10.1016/S0140-6736(04)16942-0
13 Bonafide, C. P., Localio, A. R., & Eckenhoff, M. E. (2017). Challenges in retrospective pediatric research using electronic health record data. JAMA Pediatrics, 171(12), 1103–1104. https://doi.org/10.1001/jamapediatrics.2017.2854
