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Characterization of Influenza Seasonality in China, 2010-2018: Implications for Influenza Vaccination Timing

27 Pages Posted: 28 Jan 2022

See all articles by Yilan Liao

Yilan Liao

Chinese Academy of Sciences (CAS) - State Key Laboratory of Resources and Environmental Information System

Shan Xue

Chinese Academy of Sciences (CAS) - State Key Laboratory of Resources and Environmental Information System

Yiran Xie

Chinese Center for Disease Control and Prevention (China CDC) - National Institute for Viral Disease Control and Prevention

Yanping Zhang

Division of Infectious Diseases, Chinese Center for Disease Control and Prevention

Dayan Wang

Chinese Center for Disease Control and Prevention (China CDC) - National Institute for Viral Disease Control and Prevention

Tong Zhao

Chinese Academy of Sciences (CAS) - Key Laboratory of Science and Technology on High-tech Polymer Materials

Wei Du

Southeast University

Tao Chen

Chinese Center for Disease Control and Prevention (China CDC) - National Institute for Viral Disease Control and Prevention

Hui Miao

Chinese Center for Disease Control and Prevention (China CDC)

Ying Qin

Chinese Center for Disease Control and Prevention (China CDC)

Jiandong Zheng

Chinese Center for Disease Control and Prevention (China CDC) - Division of Infectious Disease

Xiaokun Yang

Chinese Center for Disease Control and Prevention (China CDC) - Chinese National Influenza Center

Zhibin Peng

Chinese Center for Disease Control and Prevention (China CDC) - Division of Infectious Disease

Jianxing Yu

Chinese Center for Disease Control and Prevention (China CDC) - National Institute for Communicable Disease Control and Prevention

More...

Abstract

Background: Optimizing the timing of influenza vaccination based on regional temporal seasonal influenza illness patterns may make seasonal influenza vaccination more effective in China.

Methods: We obtained provincial weekly influenza surveillance data for 30 of 31 provinces in mainland China from the Chinese Center for Disease Control and Prevention for the years 2010-2018. Influenza epidemiological regions were constructed by clustering analysis. For each region, we calculated onset date, end date, and duration of seasonal influenza epidemics by the modified mean threshold method. To help identify initial vaccination target populations, we acquired weekly influenza surveillance data for four age groups (0-4, 5-18, 19-59, ≥60 years) in each region and in 171 cities of wide-ranging size. We used linear regression analyses to explore the association of epidemic onset dates by age group, city, and epidemiological region and provide evidence for initial target populations for seasonal influenza vaccination.

Findings: We determined that northern, mid, southwestern, southeast regions of mainland China have distinct seasonal influenza epidemic patterns. We found significant regional, temporal, and spatial heterogeneity of seasonal influenza epidemics. There were significant differences by age group and city size in the interval between epidemic onset in the city or age group and regional spread (epidemic lead time), with longer epidemic lead times for 5-18-year-old children and larger cities.

Interpretation: Knowledge of influenza epidemic characteristics may help optimize local influenza vaccination timing and identify initial target groups for seasonal influenza vaccination in mainland China. Similar analyses may help inform seasonal influenza vaccination strategies in other regions and countries.

Funding: National Natural Science Foundation of China (Grant No: 42171419 and 91846302)

Declaration of Interest: None to declare.

Suggested Citation

Liao, Yilan and Xue, Shan and Xie, Yiran and Zhang, Yanping and Wang, Dayan and Zhao, Tong and Du, Wei and Chen, Tao and Miao, Hui and Qin, Ying and Zheng, Jiandong and Yang, Xiaokun and Peng, Zhibin and Yu, Jianxing, Characterization of Influenza Seasonality in China, 2010-2018: Implications for Influenza Vaccination Timing (1/26/2022). Available at SSRN: https://ssrn.com/abstract=4020394 or http://dx.doi.org/10.2139/ssrn.4020394

Yilan Liao

Chinese Academy of Sciences (CAS) - State Key Laboratory of Resources and Environmental Information System ( email )

China

Shan Xue

Chinese Academy of Sciences (CAS) - State Key Laboratory of Resources and Environmental Information System ( email )

China

Yiran Xie

Chinese Center for Disease Control and Prevention (China CDC) - National Institute for Viral Disease Control and Prevention ( email )

China

Yanping Zhang

Division of Infectious Diseases, Chinese Center for Disease Control and Prevention ( email )

China

Dayan Wang

Chinese Center for Disease Control and Prevention (China CDC) - National Institute for Viral Disease Control and Prevention ( email )

China

Tong Zhao

Chinese Academy of Sciences (CAS) - Key Laboratory of Science and Technology on High-tech Polymer Materials ( email )

Beijing
China

Wei Du

Southeast University ( email )

Banani, Dhaka, Bangladesh
Dhaka
Bangladesh

Tao Chen

Chinese Center for Disease Control and Prevention (China CDC) - National Institute for Viral Disease Control and Prevention ( email )

China

Hui Miao

Chinese Center for Disease Control and Prevention (China CDC)

155 Changbai Road
Changping District
Beijing, Changping District 102206
China

Ying Qin

Chinese Center for Disease Control and Prevention (China CDC) ( email )

Jiandong Zheng

Chinese Center for Disease Control and Prevention (China CDC) - Division of Infectious Disease ( email )

China

Xiaokun Yang

Chinese Center for Disease Control and Prevention (China CDC) - Chinese National Influenza Center ( email )

China

Zhibin Peng (Contact Author)

Chinese Center for Disease Control and Prevention (China CDC) - Division of Infectious Disease ( email )

China

Jianxing Yu

Chinese Center for Disease Control and Prevention (China CDC) - National Institute for Communicable Disease Control and Prevention ( email )

Beijing
China