Below you will find various knowledge resource for influenza vaccine. These resources will be useful for those professionals  working within public health sector as well as people interested in knowing more about seasonal influenza vaccine.

Scientific and Technical Material

    Data and Statistics

    Guidelines and Training materials

    Holt Winters Method

    Recommendations: 2004

      • The Region has experienced success with regard to routine vaccine use in older adults, chronically ill or immunodeficient individuals, health professionals, pregnant women, and, more recently, children aged ≤23 months. Studies on disease burden, cost- effectiveness, and vaccine impact are being conducted to assist decision-makers on the introduction of new vaccines and maintenance of routine immunization at the national level.


        • Countries should establish and strengthen epidemiological surveillance of influenza and other acute respiratory infections to determine the characteristics of virus circulation in the countries. This recommendation is particularly important in tropical areas where more information is needed to understand the pattern of viral circulation. Gathered information will guide adequate vaccine formulation appropriate timing for vaccine administration; it will also allow countries to better measure the impact of the intervention.
        • PAHO recommends that older adults, chronically ill individuals, immunodeficient populations, health professionals, pregnant women, and children aged 6-23 months be vaccinated; priority should be given to people aged ≥60 years.
        • Countries should conduct studies that document the disease burden and economic impact of annual influenza epidemics. It is anticipated that results will support influenza immunization policies within the context of other national health priorities.
        • All the countries of the Region should develop plans, in accordance with WHO guidelines, to respond to an influenza pandemic. The recent epizootic in Asia, with the occurrence of human cases of avian flu, characterized by high case-fatality rate, demonstrated the need for countries to be prepared for a possible pandemic.
        • To help countries deal with the challenges related to influenza vaccine, PAHO should convene a group to consider issues of vaccine development, production, and procurement, and to make recommendations.

    Recommendations: 2006

      • Progress has been made in introducing influenza vaccination in the Region. The immunization of children aged 6-23 months has been introduced in 8 countries. Three additional countries are vaccinating children aged <5 years with high risk conditions.


        • All countries must strengthen the surveillance system to determine the burden of influenza, the cost-effectiveness of introducing influenza vaccine, and its impact, and to decide on the best vaccination strategy to use and when, particularly in tropical areas.
        • PAHO should provide and disseminate guidelines on the use of the vaccine to countries.
        • TAG recommends that all countries establish a seasonal influenza vaccination policy that aims to vaccinate with seasonal influenza vaccine children aged 6-23 months, health care workers, chronically ill individuals, and elderly adults.
        • Countries using the vaccine should generate vaccination coverage data and document experiences and lessons learned from targeting high-risk groups. This will be useful for countries newly introducing the vaccine and in the event of a pandemic.
        • PAHO should continue to promote mechanisms for the transfer of technology to increase Regional capacities in vaccine production and keep track of global supply.

    Recommendations: 2011

      • Progress continues to be made in the introduction of seasonal influenza vaccine in the Region. As of 2010, 39 countries and territories of the 45, or are using the vaccine in the public sector. This includes 36 countries and territories that vaccinate the elderly, 34 vaccinate heath care workers, 29 vaccinate children, 26 vaccinate persons with chronic diseases, and 17 vaccinate pregnant women.

        • Ensure that pandemic preparedness plans include the vaccination component as an integral part of the response measures.
        • Reiterate previous recommendations that countries vaccinate older adults, children those with underlying conditions, and healthcare workers. Because of the vulnerability of pregnant women to complications from influenza infection, TAG urges countries to increase vaccine uptake of pregnant women.
        • Encourage countries to strengthen their risk communication efforts and to engage scientific/professional organizations and societies in order to reach target populations.
        • Urge countries to document influenza vaccination coverage in high-risk populations. As more countries in the Region are introducing influenza vaccine, it becomes more important to assess the impact of influenza and conduct vaccine effectiveness studies in high-risk populations.
        • PAHO should continue to promote the transfer of technology for influenza vaccine production in the Region, in order to increase its availability.

    Recommendations: 2013

      • The Region of the Americas has made considerable strides in the introduction of the seasonal influenza vaccine. Among the main criteria used by the countries are TAG and WHO recommendations, and cost/effectiveness studies in countries such as Colombia and Costa Rica, among others.


          • TAG reiterates its and SAGE's previous recommendations on the vaccination of high risk groups against seasonal influenza, with special emphasis on pregnant women. Due to the vulnerability of pregnant women to complications from influenza infection, countries should strengthen vaccination of pregnant women.
          • Countries should increase vaccination coverage in healthcare workers and identify the reasons for non-vaccination in this group in order to try to reduce these obstacles.
          • Countries should improve the quality of coverage data on the influenza vaccine in high-risk populations, including the standardization of denominators.
          • TAG encourages countries to continue evaluating the effectiveness and impact of the vaccine, which entails an effort to strengthen epidemiological surveillance, as well as immunization and laboratory programs.

      Recommendations: 2014

        • The Region of the Americas has made considerable strides in the introduction of the seasonal influenza vaccine. By 2013, 40 of the 45 countries and territories of the Americas were using the seasonal influenza vaccine in the public sector to protect one or more risk groups. This includes 40 countries and territories that vaccinate the elderly, 39 that vaccinate health workers, 30 that vaccinate children (5 of them only children with chronic diseases), and 36 that vaccinate adults with chronic diseases. Great progress has been made in the vaccination of pregnant women, growing from 7 countries in 2008 to 26 countries in 2013.


          • TAG notes the progress made in influenza vaccine use and urges countries to expand the use of this vaccine and achieve higher coverage rates, in line with previous TAG and SAGE recommendations with an emphasis on pregnant women and health care workers.
          • The TAG applauds the formation and progress of the Network for Evaluation of Influenza Vaccine Effectiveness (REVELAC-i) and encourages Latin American and Caribbean countries to continue to produce evidence on the performance and impact of the influenza vaccine; and to strengthen the integration among immunization, epidemiology, and laboratory.
          • PAHO should support the continued strengthening of influenza surveillance and should analyze and present the data by geographical areas within countries, particularly in larger countries where the influenza epidemiology and seasonality varies by region.
          • PAHO should continue to provide guidance to countries on choosing the most adequate vaccine for their epidemiological and contextual situation.

      Recommendations: 2015

        • There is considerable use of seasonal influenza vaccines in the Americas. As of 2014, 40 out of 44 countries/territories in Latin America and the Caribbean (LAC) have policies for influenza vaccination that reflect the most recent World Health Organization and TAG recommendations. TAG 2015 Icon Vaccination policies target most frequently healthcare workers and the elderly (in 38 countries), followed by individuals with chronic conditions (in 35 countries), pregnant women (in 27 countries) and healthy children (in 25 countries) or children suffering chronic conditions (in 5 countries). It is worth noting that vaccination of pregnant women has substantially increased, with seven countries targeting this group in 2008 to 27 in 2014. Vaccination coverage estimates reported in the region vary widely reflecting difficulties related to data quality and completeness, absence of precise denominators for vaccine coverage estimation and other operational challenges to completing vaccination schemes among vaccine-naïve children <9 years.


          • TAG recognizes the progress of countries in strengthening influenza surveillance and expanding vaccine use across the region.
          • TAG also congratulates countries on making evidence-based changes to their vaccination policies, including changes regarding timing of influenza vaccination programs and most appropriate vaccine formulation.
          • TAG urges countries to continue generating evidence on disease burden, seasonality of influenza virus circulation, vaccine effectiveness and impact, using national data sources and appropriate methods.
          • TAG also recommends continuing the current strategies in place, vaccinating intensively prior to the peak of highest burden of influenza illness, optimally reaching very high vaccination coverage through a single campaign. Influenza vaccine should then continue to be offered to the unvaccinated through the routine health services throughout the influenza season.
          • TAG recommends that large countries carry out sub-regional seasonality analyses or stratify analyses by microclimates in order to inform vaccine use as needed.

      Technical reports: Influenza Vaccine