Influenza Related Mortality in Populations That Fail to Reach Herd Immunity

Influenza Related Mortality in Populations That Fail to Reach Herd Immunity | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Influenza Related Mortality in Populations That Fail to Reach Herd Immunity Mary Lanier, Liliya Parkman, Jared Quesada This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1236624/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Vaccines remain an important public health tool to prevent morbidity and mortality. For influenza, this requires an annual vaccination strategy due to the need to reformulate the vaccine to target circulating strains. The annual success of such vaccine efforts on the annual mortality rates is important to understand and the focus of this study. Methods Data on vaccination rates and mortality associated with Influenza was obtained from the CDC Morbidity and Mortality Weekly Reports and STATS of the States. In addition, data searches were performed using the CDC WONDER database, local and county health reports, the World Health Organization, and United States census reports. Results Annual vaccination efforts have had minimal impact on the number of influenza related deaths for those over the age of 65. Additionally, herd immunity has not been achieved in any year at the state and national levels. A closer examination of the 2017 influenza season found that the most populous states had the highest mortality burden. However, there was no correlation in local population density and an increase in influenza mortality. Conclusion Deaths associated with Influenza circulating in largely populated states are going to occur where susceptible people are regardless of whether they live in rural counties or densely populated cities. Overall, we propose that to prevent annual deaths related to seasonal influenza, herd immunity must be reached in the most populous states. Targeted vaccination of only the susceptible populations is not enough to protect them from mortality associated with influenza. Influenza Vaccine Herd Immunity Respiratory Infection Viral Infection Public Health Full Text Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1236624","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":77450710,"identity":"98768f70-50bb-48b1-a54c-e9ed4835f237","order_by":0,"name":"Mary Lanier","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAy0lEQVRIiWNgGAWjYNCCAgYGNgYGxgcMDBLEajEAa2E2IE0LELARp163/ewzCQYDuzw+9t5nlT/3WDDwt3cn4NVidibdDKgluZiN57jZbR6gdokzZzfg13IgDegeA+bENok0ttsMB4BsiVwCWs4/A2mpT2yTf8ZW+IMoLTfAthwG2sLGxsBDnJZnzBYJBscT23jSmKWBWngI++V8GuONDxXVifPbjzF+/HGgTo6/vRe/FiBgkUhA4vEQUg4CzB+IUTUKRsEoGAUjGAAA8Yk8yjVEkMYAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0003-3783-0799","institution":"SRI International","correspondingAuthor":true,"prefix":"","firstName":"Mary","middleName":"","lastName":"Lanier","suffix":""},{"id":77450711,"identity":"7e795337-3a0b-45c8-9683-ae9d1f713c46","order_by":1,"name":"Liliya Parkman","email":"","orcid":"","institution":"Samuel Merritt College: Samuel Merritt University","correspondingAuthor":false,"prefix":"","firstName":"Liliya","middleName":"","lastName":"Parkman","suffix":""},{"id":77450712,"identity":"fd9b03b9-e589-45b1-bb92-f63d42c5e210","order_by":2,"name":"Jared Quesada","email":"","orcid":"","institution":"UC San Diego Division of Biological Sciences: University of California San Diego Division of Biological Sciences","correspondingAuthor":false,"prefix":"","firstName":"Jared","middleName":"","lastName":"Quesada","suffix":""}],"badges":[],"createdAt":"2022-01-06 23:05:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1236624/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1236624/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":17510486,"identity":"a4250c95-3225-4d9e-82d7-e815e6c9c210","added_by":"auto","created_at":"2022-01-20 19:51:53","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":629687,"visible":true,"origin":"","legend":"","description":"","filename":"PremenkoLanierManuscriptText.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1236624/v1_covered.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eInfluenza Related Mortality in Populations That Fail to Reach Herd Immunity\u003c/p\u003e","fulltext":[{"header":"Full Text","content":"This preprint is available for \u003ca href='/article/rs-1236624/latest.pdf' target='_blank'\u003edownload as a PDF\u003c/a\u003e."}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Influenza, Vaccine, Herd Immunity, Respiratory Infection, Viral Infection, Public Health","lastPublishedDoi":"10.21203/rs.3.rs-1236624/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1236624/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground \u003c/strong\u003eVaccines remain an important public health tool to prevent morbidity and mortality. For influenza, this requires an annual vaccination strategy due to the need to reformulate the vaccine to target circulating strains. The annual success of such vaccine efforts on the annual mortality rates is important to understand and the focus of this study. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e Data on vaccination rates and mortality associated with Influenza was obtained from the CDC Morbidity and Mortality Weekly Reports and STATS of the States. In addition, data searches were performed using the CDC WONDER database, local and county health reports, the World Health Organization, and United States census reports. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e Annual vaccination efforts have had minimal impact on the number of influenza related deaths for those over the age of 65. Additionally, herd immunity has not been achieved in any year at the state and national levels. A closer examination of the 2017 influenza season found that the most populous states had the highest mortality burden. However, there was no correlation in local population density and an increase in influenza mortality. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e Deaths associated with Influenza circulating in largely populated states are going to occur where susceptible people are regardless of whether they live in rural counties or densely populated cities. Overall, we propose that to prevent annual deaths related to seasonal influenza, herd immunity must be reached in the most populous states. 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