Influenza B Circulation and Vaccine Effectiveness Against Medically Attended Outpatient Influenza B Illness, United States, 2016–17 Through 2024–25

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ID: 337979
2026
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Abstract
Abstract Background Influenza B vaccine effectiveness (VE) has varied by season, lineage, antigenic drift, and vaccine composition. After B/Yamagata detection ceased globally, trivalent vaccines containing B/Victoria were reintroduced in 2024–25. We evaluated influenza B circulation and VE across eight analyzed seasons spanning this transition. Methods Ambulatory patients aged ≥6 months with acute respiratory illness were enrolled at U.S. Flu VE Network sites during eight influenza seasons from 2016–17 through 2024–25; 2020–21 was excluded because influenza circulation was negligible. Participants were tested by RT-PCR. Lineage-specific VE was estimated using a test-negative design and logistic regression adjusted for age, sex, race/ethnicity, calendar time, and study site. VE was reported for season-lineage strata with ≥50 influenza B cases. Results Among 65,773 participants, 3,629 influenza B cases were included in lineage-specific VE analyses (1,507 B/Yamagata; 2,122 B/Victoria). Six of 10 season-lineage strata met the reporting threshold. B/Victoria VE was 58% (95% CI, 28%–77%) in 2016–17, 51% (43%–57%) in 2019–20, 78% (71%–84%) in 2023–24, and 39% (14%–56%) in 2024–25. B/Yamagata VE was 55% (46%–63%) in 2016–17 and 49% (40%–56%) in 2017–18. Conclusions Influenza vaccines protected against medically attended outpatient influenza B illness, although VE varied by season. Continued VE monitoring and genetic surveillance are needed to detect emerging influenza B viruses and inform vaccine strain selection.
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Authors Jessica Meeker, A. Jackson, Emily Toth Martin, Ivana A. Vaughn, Karen J. Wernli, C. Hallie Phillips, Manjusha Gaglani, Chandni Raiyani, Huong Q. Nguyen, Jennifer P. King, Stacey L. House, Jamie Mills, Vel Murugan, Lora Nordstrom, Elie Antoun Saade, Kiran A. Faryar, Richard Kent Zimmerman, Krissy Moehling Geffel, Emmanuel B. Walter, Natalie A.B. Bontrager, Jessie R. Chung, Brendan L. Flannery, Sascha Ellington, US Flu VE Network Investigators, Spencer Rose, Amanda McKillop, Nicole Calhoun, Britain Fairall, Marcus Volz, Manohar B. Mutnal, Arundhati Rao, Jason D. Ramm, Tresa McNeal, Keith Stone, Madhava Beeram, Eric Hoffman, Dedra Preece, Kayan Dunnigan, Leah Odame‐Bamfo, Jason A. Ettlinger, Courtney Shaver, Monica Bennett, Elisa Priest, Jennifer Thomas, Javed Butler, Muralidhar Jatla, Jesus Vallejo
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Journal The Journal of infectious diseases
Year 2026
DOI
10.1093/infdis/jiag538
URL
https://doi.org/10.1093/infdis/jiag538
Keywords Keywords not found

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