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We examined public understanding of wastewater surveillance (WS) data and perceptions of its importance by using a nationwide cross-sectional survey. Approximately half of participants were aware of WS, and 79.0% responded that WS information about viruses was important, highlighting the need for community engagement about WS use and value.
The United States National Wastewater Surveillance System, established in 2020, provides public access to timely data about infectious diseases that might be circulating in a community ( 1 ). Clinicians, public health officials, and the general public can use this information to guide action ( 2 , 3 ). Despite broad implementation, less is known about how the public interprets wastewater surveillance (WS) data or perceives its value ( 4 – 6 ). We examined public understanding of WS data and perceptions of its importance.
We collected data by using the PN View survey ( https://styles.porternovelli.com/pn-view-panels ), a nationwide cross-sectional online survey conducted by Porter Novelli Public Services and Big Village. The voluntary survey was administered from August 22–24, 2025, to adults > 18 years of age in the United States sampled by using nonprobability quota sampling. Porter Novelli computed survey weights by using a proprietary process to reflect the United States population demographic composition in sex, age, region, race and ethnicity, and education on the basis of Current Population Survey proportions ( Appendix Table). We followed the Checklist for Reporting Results of Internet E-Surveys guidelines ( 7 ).
Participants were asked to select the definition of WS that best matched their understanding, interpret a figure depicting wastewater detections of a hypothetical vaccine-preventable respiratory virus, and identify actions they would take if the virus was detected in their community. We collected participants’ opinions on the importance of the information provided by WS by using an open-text field ( Appendix ). We performed weighted quantitative analyses in Stata version 18.0 (StataCorp, LLC, https://www.stata.com ); we analyzed free-text responses in MAXQDA 24 ( https://www.maxqda.com/new-maxqda-24 ).
This activity was reviewed and deemed not research by the National Center for Emerging and Zoonotic Infectious Diseases Human Subjects Advisor at the Centers for Disease Control and Prevention (CDC) and conducted according to CDC Human Research Protection Program Standard Operating Procedures, consistent with applicable federal law and CDC policy. Although Porter Novelli Public Services and Big Village did not require Institutional Review Board review, they adhere to European Society for Opinion and Marketing Research ethical standards.
Figure . Actions participants intend to take after wastewater detections of a hypothetical vaccine-preventable virus in their area (n = 1,014) from Porter Novelli View survey, United States, August 2025. Bars indicate...
Of 1,014 participants, 51.0% (95% CI 47.8%–54.2%) were female and 48.5% (95% CI 45.3–51.7) male; 60.8% (95% CI 57.5%–63.9%) were non-Hispanic White, and…