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Article History

Received: 24 July 2025

Accepted: 30 October 2025

First Online: 28 November 2025

Declarations

:

: DA receives consultant fees as member of Sanofi´s scientific advisory board. HH is a stock owner and member of the board of Vactech Oy which develops vaccines against picornaviruses. KFL, EWT, APA, JEL, JFP and REL do not have any conflict of interest to declare.

: Written informed consent was obtained from all families. All research was performed in accordance with relevant regulations, and the study was performed in accordance with the Declaration of Helsinki. The study design and recruitment was approved by local U.S. Institutional Review Boards and European Ethics Committee Boards in Colorado’s Colorado Multiple Institutional Review Board 04–0361, Georgia’s Medical College of Georgia Human Assurance Committee (2004–2010), Georgia Health Sciences University Human Assurance Committee (2011–2012), Georgia Regents University Institutional Review Board (2013–2016), Augusta University Institutional Review Board (2017-present) HAC 0405380, Florida’s University of Florida Health Center Institutional Review Board IRB201600277, Washington state’s Washington State Institutional Review Board (2004–2012) and Western Institutional Review Board (2013–2019), WCG IRB (2020-present) 20130211, Finland’s Ethics Committee of the Hospital District of Southwest Finland Dnro168/2004, Germany’s Bayerischen Landesärztekammer (Bavarian Medical Association) Ethics Committee 04089, Sweden’s Regional Ethics Board in Lund, Sect. 2 (2004–2012) and Lund University Committee for Continuing Ethical Review (2013–2021), Swedish Ethical Review Authority (2022-present) 217/2004 and the study is monitored by External Advisory Board formed by the National Institutes of Health.