What might this flu season have in store?

Influenza cases and deaths in the United States and worldwide dropped to unprecedented lows between October 3, 2020, and July 24, 2021, according to CDC data. In a typical season, 75 to 150 children die of influenza in the United States, noted pediatric infectious disease specialist Paul Offit, MD, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, in a recent JAMA Network article. Last influenza season, he said, one child was reported to have died.

Except for a few places, such as western Africa, influenza “was essentially nowhere” last season, said virologist Richard Webby, PhD, of St. Jude Children’s Research Hospital, in the same article.

Several what ifs will determine the upcoming season’s magnitude: the COVID-19 pandemic’s severity this fall and winter; the extent to which SARS-CoV-2 mitigation measures continue to be used; and how well vaccines are matched to circulating influenza viruses.

The unexpected decline of influenza cases during the COVID-19 pandemic “certainly showed that many of the social-distancing things we were doing were very effective,” said Vanderbilt University School of Medicine infectious disease and health policy professor William Schaffner, MD. Schaffner also cited the halt of international travel and closing of schools, keeping children at home and away from each other.

Influenza vaccine manufacturers project they will deliver 188 million to 200 million doses in the United States for the upcoming influenza season. GlaxoSmithKline recently announced that it expects to distribute 50 million doses of its influenza vaccine in the United States, more than in any previous season.