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We welcome Thedi Ziegler and colleagues’ Comment on the WHO Global Influenza Surveillance and Response System and believe its proposals could strengthen global sentinel surveillance.1 We respond to this Comment from the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), one of Europe's oldest sentinel networks.2 The RSC is a collaboration between the University of Oxford, RCGP, and the UK Health Security Agency. The UK Health Security Agency's respiratory virus reference laboratory has provided data to the Global Influenza Surveillance and Response System and its predecessors since 1950. The RSC has grown substantially throughout the pandemic and, therefore, we are well placed to comment on the strategic and operational implications of the proposals.3 We support the principle of year-round integrated respiratory surveillance and the broadening of laboratory testing to other respiratory viruses. Furthermore, we agree that measuring disease severity will support effective public health decision making. However, we should not overlook the importance of quality clinical data reporting and sufficient representative sampling to evaluate performance of diverse influenza and COVID-19 vaccine types across primary and secondary care networks. Additionally, longitudinal data enable prompt detection of changes in disease incidence, and routine surveillance with serology can also provide insights into heterogeneous population immunity.4

sampling to evaluate performance of diverse influenza and COVID-19 vaccine types across primary and secondary care networks. Additionally, longitudinal data enable prompt detection of changes in disease incidence, and routine surveillance with serology can also provide insights into heterogeneous population immunity.4 The RSC's rapid expansion and improved digital maturity through the pandemic have shown that surveillance systems can be a test bed for innovation.3 The integration of data from near-patient diagnostics into the RSC surveillance system's dataset and the evaluation of interventions (eg, antiviral therapies and new vaccines) are examples of such innovation.5 Growth, however, comes at a cost, and if improvements are to be sustained and built upon, necessary investment in personnel and resources is essential.