Self-testing for 5 respiratory viruses in adult VACCELERATE volunteers in Germany—a pilot study on multi-pathogen rapid antigen testing to monitor community-acquired acute respiratory infections

This prospective pilot study assessed the real-time epidemiology of acute respiratory infections (ARI) in Germany using self-administered, multi-pathogen antigen rapid testing among adult volunteers from the VACCELERATE Registry. Adults received a single-swab laminar-flow immunochromatographic device (MAK5) detecting SARS-CoV-2, influenza A/B, RSV, and adenovirus. Between December 7, 2022, and June 2, 2023, 1,429/1,952 recipients reported self-testing: 1,119 experienced ARI symptoms and self-tested by May 31, 2023. Among symptomatic testers, 32.1% (359/1,119) were positive, yielding 377 pathogen detections and 17 co-detections (1.5%). Detections were SARS-CoV-2 47.2%, RSV 28.9%, influenza A 19.6%, ADV 2.7%, and influenza B 1.6%. Symptom profiling showed that influenza A positives more frequently reported cough (91%), fever (59.7%), and myalgia (≈43%) than those positive for RSV or SARS-CoV-2. Rhinitis predominated among ADV (80%), RSV (79.3%), and SARS-CoV-2 (69.7%). Overall symptom burden was higher for influenza A. Temporal and geographical analyses reflected expected seasonality for most viruses, with RSV detected both in-season and...