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The influenza virus circulates continuously, causing regional epidemics and outbreaks, leading to thousands of deaths. For instance, according to the Centers for Disease Control and Prevention (CDC) data statistics, more than 13 million flu cases were recorded so far in the 2019-20 timeframe. The changing character of the virus is compelling an annual change in the vaccine strain to match the influenza virus strain worldwide. The increasing prevalence of influenza epidemics and seasonal outbreaks is likely to expand the product sales during the projected period. There are numerous licensed seasonal influenza vaccines recommended by the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and other governmental organizations to help fight the disease in the current market scenario. Governments have focused on advising people to get vaccinated early to provide maximum protection during the flu season. Moreover, pharmaceutical companies are continually facing new challenges in developing a suitable vaccine against a particular strain. Therefore, the rising demand for effective flu vaccines is anticipated to surge the global market. The coronavirus pandemic naturally impacted the routine immunization programs and campaigns conducted worldwide in developing and developed countries. However, Flu vaccination rates have gone up considerably during the pandemic owing to factors such as push from health experts/health departments as well as extension/expansion of various government programs that provide free vaccination against the flu. Additionally, growing awareness among the public about the higher risk of getting infected with COVID-19 if the flu weakens the immune system is also another factor contributing to the uptake of flu vaccines. For instance, according to the Centers for Disease Control & Prevention (CDC), as of May, over 189.4 million flu vaccines for the 2020-2021 flu season have been distributed in the U.S compared to 174 million in the 2019-2020 season. Growing prevalence ...

• Editorial?• "The proportions assumed by the epidemic of so-called 'Spanish influenza,' in training camps and among civilians, make it important for us to approach as nearly as possible to the happy medium between panic on one hand and the fatalistic assumption that it is 'in the air,' anyway, and that, consequently, there is no use trying to evade it."• Warn against giving into fear because this will make it easier to catch the disease. • Not necessary to quarantine an entire household because one member is ill. There are simple methods, such as those followed in cantonments "where sufficient isolation is obtained by simple methods which reduce inconvenience to the minimum." For example, the nurse attending a patient wears a gown that is removed before they leave the sick room. • Good idea to follow common rules of sanitation and hygiene. Avoid crowds but do not inconvenience yourself unduly to avoid them. Avoid people who are openly sick. Cough or sneeze into a handkerchief. Avoid overeating and exercise. Get plenty of fresh air. • Gives a brief history of influenza, which has been known of since 1323. It was known in America as "Jackson's itch" in 1829 and "Tyler's grippe" during Tyler's political career. • "By whatever name it is called, it is vicious enough. The present epidemic will run its course, as others have done, but meanwhile we are called upon to keep cool about it, to adopt sane and simple precautions, and avoid spreading it when these precautions fail." ; Newspaper article ; 6

• Few communities where influenza has not spread • Disease most prevalent in naval training stations and military camps • In past 48 hours, 32 deaths have been reported • Dr. Thomas Leen, died after attending to sailors with influenza ; Newspaper article ; 1

• "There is no record of any epidemic in this country so fatal as the present influenza scourge."• "The casualties fatal and otherwise at the battlefronts are trifling compared to the frightful list of victims of the epidemic now raging in the eastern states."• "The military camps suffer very severely, the number of deaths being quite alarming."• "The government is providing more effective methods of treatment than were possible when the epidemic first appeared."• "Happily the disease is subsiding at Camp Devens and it is hoped this marks it [sic] early disappearance."• "Most of the local factories are freely using strong disinfectants and some are turning out their employes [sic] into the open air for half an hour in the forenoon and again in the afternoon on the assumption that fresh air and sunshine are among the best disinfectants." • "It would be well that the street railway company would use disinfectants in its cars at least once a day.but unless this is ordered by the health board it will not be done"• "Dr. Leary, bacteriologist at Tufts College, however, announces the discovery of a serum that the Washington authorities regard as likely to prove effective in the treatment of the disease."• "They have determined to give it (serum) a scientific test, and already it is claimed that good results have been obtained from its use."• Henry B. Endicott, chairman of the emergency health committee of Boston is very active in sending out antigrippe supplies to state boards wherever needed."• "So many doctors and nurses have fallen victims to this disease that the medical profession regards it as one of the most dangerous and insidious with which they have to deal."• "Let everyone adopt the preventative measures recommended."• "It is noticeable that a very large proportion of the victims of the influenza are foreigners.here is another important reason why all foreigners should be compelled to use the English language."• "In the present instance, not only are they themselves the victims, but they become a menace to the rest of the community by their failure to adopt the ordinary precautions against the spread of the disease." ; Newspaper article ; 6

• Reports indicate that influenza has begun to spread among the civilian population of the state• In some sections of Minnesota it has reached stages closely resembling an epidemic• The State Board of Health is expected to meet today to discuss steps that may be necessary in combating the disease• 23 total cases under treatment at University Hospital, none of which is thought to be in serious condition• [Military]• Of the 5 military deaths in the Twin Cities, 2 were from Fort Snelling and 3 were from Dunwoody Naval Institute. All of the deaths occurred at the Minneapolis City Hospital• 34 new cases reported at Fort Snelling• 650 total cases being treated at Fort Snelling• [Minneapolis]• Nonpublic hospitals of Minneapolis have volunteered to relieve the City hospital of all regular City hospital patients other than those having influenza so City hospital can care for only influenza victims ; Newspaper article ; 1, 5

• A joint influenza committee will study the epidemic and compare data gathered from various government departments ; Newspaper article ; 22

• Washington – Officials fear Spanish Influenza has been brought to Atlantic Coast cities by American transports• "There is little means of combating the disease except by absolute quarantine and that obviously is impossible"• Government may issue country-wide warnings and general instructions on how to avoid infection ; Newspaper article ; 7

• Philadelphia has "but a score or so of cases" • "Thus far its extreme ravages in this country have been confined to a few localities, but the Washington health authorities already have declared it to be 'pandemic' . . ."• Disease reported to be related to Russian influenza, but "it seems to develop more quickly into pneumonia and the consequential heart troubles, and therefore produces a somewhat startling rate of mortality, particularly among its victims who are in what is generally called the prime of life, but who have some lurking weakness or have not retained the possession in full of their normal powers of resistance."• Military camps are being quarantined ; Newspaper article ; 6

Kenntnis und Informationsgrad über die pandemische Grippe H1N1. Meinung über und Absicht zur Impfung. Maßnahmen zur Vorbeugung. Schweinegrippe in den Medien. Institutionenvertrauen.

• City council to pass ordinance to make influenza quarantinable, penalize failure to report cases by doctors, lodging housekeepers, etc.• Special meeting called for this purpose• If authority not given to quarantine, ban will have to be re-imposed ; Newspaper article ; 4

This symposium summarizes the opinions of several widely known health workers on the modes of infection, spread, prevalence and nature, epidemiology, and legislative and executive management of influenza and pneumonia—the two diseases which so greatly increased our morbidity rates during the winter season.

• Surgeon General Rupert Blue issues a list of advice for identifying and treating Spanish influenza.• This list addresses Sources of Infection, Incubation, Transmission, Communicability, Methods of Control, Recognition of the Disease, Isolation of Patients, Immunization, Quarantine (as an impractical response), Concurrent- and Terminal Disinfection, and general preventative measures.• A list of nurses delegated to various military camps is included. ; Newspaper article ; 14