Influenza vaccine effectiveness against outpatient acute respiratory illness with laboratory-confirmed influenza, United States, 2024–25 season

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ID: 321039
2026
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Abstract
BACKGROUND: Influenza A(H1N1)pdm09 and A(H3N2) viruses predominated during the 2024-25 U.S. influenza season. We estimated influenza vaccine effectiveness (VE) in the United States against mild-to-moderate outpatient influenza illness by influenza type and subtype in the 2024-25 season. METHODS: We enrolled outpatients aged ≥8 months with acute respiratory illness symptoms including cough from outpatient health clinics, urgent care clinics, and emergency departments in 7 states. Upper respiratory specimens were tested for influenza type/subtype by reverse-transcriptase polymerase chain reaction (RT-PCR). Influenza VE was estimated with a test-negative design comparing odds of testing positive for influenza among vaccinated versus unvaccinated participants controlling for age, study site, underlying health status, and month of illness onset. We also estimated VE of current season vaccination among adults stratified by prior season vaccination status. RESULTS: Among 6,793 enrolled patients, 2,016 (30%) tested positive for influenza including 961 A(H3N2), 770 A(H1N1)pdm09, and 183 B/Victoria. Overall vaccine effectiveness against any influenza illness was 33% (95% Confidence Interval [CI]: 24 to 41): 27% (95% CI: 14 to 39) against influenza A(H3N2), 37% (95% CI: 24 to 48) against A(H1N1)pdm09, and 40% (95% CI: 12 to 59) against B/Victoria. We did not detect statistically significant interaction between current and prior season vaccination. CONCLUSIONS: Influenza vaccination during the 2024-25 season protected against circulating influenza viruses, reducing the risk of outpatient medically attended influenza overall by approximately one-third among people who were vaccinated.
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Authors Jessie R Chung, Ashley M Price, Stacey L House, Jamie Mills, Karen J Wernli, Magali Sanchez, Emily T Martin, Ivana A Vaughn, Vel Murugan, Joanna Kramer, Elie A Saade, Kiran Faryar, Manjusha Gaglani, Chandni Raiyani, Richard K Zimmerman, Louise H Taylor, Olivia L Williams, Emmanuel B Walter, Juliana DaSilva, Marie K Kirby, Min Z Levine, Rebecca Kondor, Emma K Noble, Kelsey M Sumner, Sascha R Ellington, Brendan Flannery, US Flu VE Network Investigators, Tamair Curley, Jeremy Russell, Ben Rapp, Joshua Jackson, Erika Kiniry, Brianna Wickersham, Rachael Doud, Matthew Nguyen, Arnold S Monto, Donny Hearn, Caroline K Cheng, Maria Santana-Garces, Muniza Hossain, Shane Bole, Mehal Patel, Lora Nordstrom, Matthew Scotch, Bradley Bobbett, Alexia El Khoury, Joy Abou Farah, Tracy Lemonovich, Curtis Donskey, Spencer Rose, Michael Smith, Leah Odame-Bamfo, Kempapura Murthy, Mufaddal Mamawala, Amanda McKillop, Nicole Calhoun, Britan Fairall, Mary Patricia Nowalk, G K Balasubramani, Tracey Conti, David A Figucia, Alexandra Weissman, Natalie A B Bontrager, Darren J Morrow, Wes Rountree, Christopher A Todd, Cameron R Wolfe, Lisa Keong, Sydney R Sheffield, Julia C Frederick, Malania M Wilson, Ewelina Lyszkowicz, Yujin Jung, Crystal Holiday, Stacie Jefferson, Philip Shirk
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Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Year 2026
DOI
10.1093/cid/ciag437
URL
https://doi.org/10.1093/cid/ciag437
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