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Vaccine. 2019 Apr 8. pii: S0264-410X(19)30436-0. doi: 10.1016/j.vaccine.2019.03.081. [Epub ahead of print]

Influenza in Latin America: A report from the Global Influenza Initiative (GII).

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Ricardo Gutiérrez Children's Hospital, 1405 Buenos Aires, Argentina. Electronic address:
Netherlands Institute for Health Services Research (NIVEL), 3513 CR Utrecht, the Netherlands. Electronic address:
Department of Medicine, Federal University of São Paulo, 04024-002 São Paulo, Brazil. Electronic address:
Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, University of Chile, 1058 Santiago, Chile. Electronic address:
Department of Virology, Central Laboratory for Public Health, 1429 Asunción, Paraguay.
Tropical Medicine Institute Daniel A. Carrion, Virology Section, San Marcos University, 15081 Lima, Peru.
University of Pennsylvania, Vaxconsult, Doylestown, PA 18907, USA. Electronic address:


The Global Influenza Initiative (GII) is a global expert group that aims to raise acceptance and uptake of influenza vaccines globally and provides recommendations and strategies to address challenges at local, national, regional, and global levels. This article provides a consolidated estimation of disease burden in Latin America, currently lacking in published literature, and delivers the GII recommendations specific to Latin America that provide guidance to combat existing vaccination challenges. While many countries worldwide, especially in the tropics and subtropics, do not have a seasonal influenza policy, 90% of Latin American countries have a seasonal influenza policy in place. Local governments in the Latin American countries and The Pan American Health Organization's Technical Advisory Group on Vaccine-preventable Diseases play a major role in improving the vaccination coverage and reducing the overall disease burden. Influenza seasonality poses the biggest challenge in deciding on optimal timing for vaccination in Latin America, as in temperate climates seasonal influenza activity peaks during the winter months (November-February and May-October) in the northern and southern hemispheres, respectively, while in the tropics and subtropical regions it usually occurs throughout the year, but especially during the rainy season. Besides this, vaccine mismatch with circulating strains, misconception concerning influenza vaccine effectiveness, and poor disease and vaccine awareness among the public are also key challenges that need to be overcome. Standardization of clinical case definitions is important across all Latin American countries. Surveillance (mostly passive) has improved substantially in the Latin American countries over the past decade, but more is still required to better understand the disease burden and help inform policies.


Epidemiology; Global Influenza Initiative; Influenza; Latin America; Surveillance; Vaccination

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