{"id":27179,"date":"2026-10-13T17:25:40","date_gmt":"2026-10-13T15:25:40","guid":{"rendered":"https:\/\/www.proefschriftmaken.nl\/portfolio\/susanne-heemskerk\/"},"modified":"2026-10-31T11:39:04","modified_gmt":"2026-10-31T10:39:04","slug":"susanne-heemskerk","status":"publish","type":"us_portfolio","link":"https:\/\/www.proefschriftmaken.nl\/en\/portfolio\/susanne-heemskerk\/","title":{"rendered":"Susanne Heemskerk"},"content":{"rendered":"","protected":true},"featured_media":27180,"template":"","meta":{"_acf_changed":false},"university_us_portfolio":[25],"class_list":["post-27179","us_portfolio","type-us_portfolio","status-publish","post-password-required","hentry","university_us_portfolio-universiteit-utrecht"],"acf":{"main_text":"","naam_van_het_proefschift":"MONITORING RSV IN THE ERA OF IMMUNIZATION","samenvatting":"Respiratory syncytial virus (RSV) is a major cause of respiratory infections in young children. The RSV landscape has changed considerably in recent years, with the COVID-19 pandemic disrupting its usual seasonality and the development and introduction of new preventive strategies, including long-acting monoclonal antibodies and maternal vaccination. Reliable estimates of RSV burden and robust surveillance are therefore important to inform immunization policy and to evaluate its impact after implementation. \nThis thesis aimed to improve understanding of RSV burden and seasonality in children and to explore how methodological approaches and surveillance can provide more reliable evidence for decision-making. We showed that RSV causes substantial burden in primary care and emergency departments, particularly among infants, but that reported incidence estimates vary widely due to differences in study design, case definitions, age groups and testing practices. By applying a multilevel meta-analysis, we accounted for part of this heterogeneity and generated more robust estimates of RSV incidence across age groups and healthcare settings. \nWe also examined RSV seasonality during the COVID-19 pandemic. RSV circulation changed markedly across Europe, but the relationship between individual non-pharmaceutical interventions and RSV activity was difficult to disentangle and depended partly on how interventions and surveillance data were recorded. These findings highlight the importance of considering contextual and methodological differences when interpreting RSV trends and planning immunization strategies. \nTo complement these findings, we evaluated retrospective hospital-based surveillance of vaccine-preventable diseases in a Dutch tertiary pediatric hospital. RSV was the main contributor of the observed VPD-related hospital burden, accounting for a large proportion of intensive care admissions and hospital days. Routinely collected hospital data could provide information on disease burden, severity, vaccination status and potential preventability, demonstrating the potential of hospital-based surveillance while also revealing limitations in case ascertainment and data completeness. \nIn the general discussion, these findings were brought together to evaluate the current RSV surveillance landscape in the Netherlands. Existing surveillance systems provide valuable information on RSV circulation, seasonality and healthcare use, but important gaps remain. These concern the representation of young children, the availability of population denominators, continuity of pediatric hospital surveillance and linkage with immunization data. Strengthening and better integrating surveillance across community, primary care, hospital and laboratory settings could provide a more complete and sustainable basis for evaluating immunization impact and supporting future public health decisions.","summary":"Respiratory syncytial virus (RSV) is a major cause of respiratory infections in young children. The RSV landscape has changed considerably in recent years, with the COVID-19 pandemic disrupting its usual seasonality and the development and introduction of new preventive strategies, including long-acting monoclonal antibodies and maternal vaccination. Reliable estimates of RSV burden and robust surveillance are therefore important to inform immunization policy and to evaluate its impact after implementation. \nThis thesis aimed to improve understanding of RSV burden and seasonality in children and to explore how methodological approaches and surveillance can provide more reliable evidence for decision-making. We showed that RSV causes substantial burden in primary care and emergency departments, particularly among infants, but that reported incidence estimates vary widely due to differences in study design, case definitions, age groups and testing practices. By applying a multilevel meta-analysis, we accounted for part of this heterogeneity and generated more robust estimates of RSV incidence across age groups and healthcare settings. \nWe also examined RSV seasonality during the COVID-19 pandemic. RSV circulation changed markedly across Europe, but the relationship between individual non-pharmaceutical interventions and RSV activity was difficult to disentangle and depended partly on how interventions and surveillance data were recorded. These findings highlight the importance of considering contextual and methodological differences when interpreting RSV trends and planning immunization strategies. \nTo complement these findings, we evaluated retrospective hospital-based surveillance of vaccine-preventable diseases in a Dutch tertiary pediatric hospital. RSV was the main contributor of the observed VPD-related hospital burden, accounting for a large proportion of intensive care admissions and hospital days. Routinely collected hospital data could provide information on disease burden, severity, vaccination status and potential preventability, demonstrating the potential of hospital-based surveillance while also revealing limitations in case ascertainment and data completeness. \nIn the general discussion, these findings were brought together to evaluate the current RSV surveillance landscape in the Netherlands. Existing surveillance systems provide valuable information on RSV circulation, seasonality and healthcare use, but important gaps remain. These concern the representation of young children, the availability of population denominators, continuity of pediatric hospital surveillance and linkage with immunization data. Strengthening and better integrating surveillance across community, primary care, hospital and laboratory settings could provide a more complete and sustainable basis for evaluating immunization impact and supporting future public health decisions.","auteur":"Susanne Heemskerk","auteur_slug":"susanne-heemskerk","publicatiedatum":"11 december 2026","taal":"EN","url_flipbook":"https:\/\/ebook.proefschriftmaken.nl\/ebook\/susanneheemskerk?iframe=true","url_download_pdf":"https:\/\/ebook.proefschriftmaken.nl\/download\/46b789f0-f7f2-4f10-86df-9a061d111060\/highres","url_epub":"","ordernummer":"19179","isbn":"978-94-6534-633-5","doi_nummer":"10.33540\/3740","naam_universiteit":"Universiteit Utrecht","afbeeldingen":27180,"video_url":"","podcast_url":"","naam_student:":"","binnenwerk":"","universiteit":"Universiteit Utrecht","cover":"","afwerking":"","cover_afwerking":"","design":""},"_links":{"self":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio\/27179","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio"}],"about":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/types\/us_portfolio"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/media\/27180"}],"wp:attachment":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/media?parent=27179"}],"wp:term":[{"taxonomy":"university_us_portfolio","embeddable":true,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/university_us_portfolio?post=27179"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}