Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 8;76(3):540-549.
doi: 10.1093/cid/ciac653.

Influenza During the 2010-2020 Decade in the United States: Seasonal Outbreaks and Vaccine Interventions

Ryan E Malosh  1 , Ian McGovern  2 , Arnold S Monto  3
Affiliations

Influenza During the 2010-2020 Decade in the United States: Seasonal Outbreaks and Vaccine Interventions

Ryan E Malosh et al. Clin Infect Dis. .

Abstract

The 10 years between the last influenza pandemic and start of the severe acute respiratory syndrome coronavirus 2 pandemic have been marked by great advances in our ability to follow influenza occurrence and determine vaccine effectiveness (VE), largely based on widespread use of the polymerase chain reaction assay. We examine the results, focusing mainly on data from the United States and inactivated vaccines. Surveillance has expanded, resulting in increased ability to characterize circulating viruses and their impact. The surveillance has often confirmed previous observations on timing of outbreaks and age groups affected, which can now be examined in greater detail. Selection of strains for vaccines is now based on enhanced viral characterization using immunologic, virologic, and computational techniques not previously available. Vaccine coverage has been largely stable, but VE has remained modest and, in some years, very low. We discuss ways to improve VE based on existing technology while we work toward supraseasonal vaccines.

Keywords: influenza; influenza vaccines; public health surveillance; sentinel surveillance; vaccine effectiveness.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. I. M is an employee of Seqirus USA Inc and reports holding stock in CSL Ltd, the parent company of Seqirus. A. S. M. reports a NIAID contract (75N9302.ic.00015), unrelated to this work. R. E. M. reports no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Strain predominance by influenza season for the overall population (A) and by age group (B).
Figure 2.
Figure 2.
Average percentage of influenza A vs B by week, 2010–2011 through 2019–2020.
Figure 3.
Figure 3.
Timing and duration of influenza outbreaks. Timing of peak (point) and duration (line) of influenza outbreaks as assessed based on influenza-like illness (ILI) data and the Moving Epidemic Method (MEM). The 2014–2015 season had a 53rd week not pictured here, whereas the rest had 52 weeks.
Figure 4.
Figure 4.
Rate of influenza medical visits and hospitalizations by age group. Abbreviation: US, United States.
Figure 5.
Figure 5.
Vaccination coverage by season and age group—United States.
Figure 6.
Figure 6.
Vaccine effectiveness in preventing medically attended illnesses: overall by age (A) and for all ages by influenza type (B).
Figure 7.
Figure 7.
Proportion of circulating influenza A(H3N2) viruses tested that were antigenically similar to cell- and egg-propagated reference viruses.
See this image and copyright information in PMC

References

    1. Ortiz JR, Sotomayor V, Uez OC, et al. . Strategy to enhance influenza surveillance worldwide. Emerg Infect Dis 2009; 15:1271–8. - PMC - PubMed
    1. Hay AJ, McCauley JW. The WHO global influenza surveillance and response system (GISRS)—a future perspective. Influenza Other Respir Viruses 2018; 12:551–7. - PMC - PubMed
    1. Stuurman AL, Biccler J, Carmona A, et al. . Brand-specific influenza vaccine effectiveness estimates during 2019/20 season in Europe—results from the DRIVE EU study platform. Vaccine 2021; 39:3964–73. - PubMed
    1. Skowronski DM, Leir S, Sabaiduc S, et al. . Influenza vaccine effectiveness by A (H3N2) phylogenetic subcluster and prior vaccination history: 2016–2017 and 2017–2018 epidemics in Canada. J Infect Dis 2022; 225:1387–98. - PMC - PubMed
    1. Centers for Disease Control and Prevention . US influenza surveillance: purpose and methods.2021. Available at: https://www.cdc.gov/flu/weekly/overview.htm. Accessed 31 May 2022.

Publication types

Substances