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BackgroundEstimates of influenza disease burden are broadly useful for public health, helping national and local authorities monitor epidemiologic trends, plan and allocate resources, and promote influenza vaccination. Historically, estimates of the burden of seasonal influenza in the United States, focused mainly on influenza‐related mortality and hospitalization, were generated every few years. Since the 2010‐2011 influenza season, annual US influenza burden estimates have been generated and expanded to include estimates of influenza‐related outpatient medical visits and symptomatic illness in the community.MethodsWe used routinely collected surveillance data, outbreak field investigations, and proportions of people seeking health care from survey results to estimate the number of illnesses, medical visits, hospitalizations, and deaths due to influenza during six influenza seasons (2010‐2011 through 2015‐2016).ResultsWe estimate that the number of influenza‐related illnesses that have occurred during influenza season has ranged from 9.2 million to 35.6 million, including 140 000 to 710 000 influenza‐related hospitalizations.DiscussionThese annual efforts have strengthened public health communications products and supported timely assessment of the impact of vaccination through estimates of illness and hospitalizations averted. Additionally, annual estimates of influenza burden have highlighted areas where disease surveillance needs improvement to better support public health decision making for seasonal influenza epidemics as well as future pandemics.

this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).Although COVID-19-associated hospitalizations and deaths have occurred more frequently in adults, † COVID-19 can also lead to severe outcomes in children and adolescents (1,2). Schools are opening for in-person learning, and many prekindergarten children are returning to early care and education programs during a time when the number of COVID-19 cases caused by the highly transmissible B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19, is increasing. § Therefore, it is important to monitor indicators of severe COVID-19 among children and adolescents. This analysis uses Coronavirus Disease 2019-Associated Hospitalization Surveillance Network (COVID-NET) ¶ data to describe COVID-19-associated hospitalizations among U.S. children and adolescents aged 0-17 years. During March 1, 2020-August 14, 2021, the cumulative incidence of COVID-19-associated hospitalizations was 49.7 per 100,000 children and adolescents. The weekly COVID-19-associated hospitalization rate per 100,000 children and adolescents during the week ending August 14, 2021 (1.4) was nearly five times the rate during the week ending June 26, 2021 (0.3); among children aged 0-4 years, the weekly hospitalization rate during the week ending August 14, 2021, was nearly 10 times that during the week ending June 26, 2021.** During June 20-July 31, 2021, the hospitalization rate among unvaccinated adolescents (aged 12-17 years) was 10.1 times higher than that among fully vaccinated adolescents. Among all hospitalized children and adolescents with COVID-19, the proportions * These authors contributed equally to this report.

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Assessments of influenza season severity can guide public health action. We used the moving epidemic method to develop intensity thresholds (ITs) for 3 US surveillance indicators from the 2003-2004 through 2014-2015 influenza seasons (excluding the 2009 pandemic). The indicators were: 1) outpatient visits for influenza-like illness; 2) influenza-related hospitalizations; and 3) influenza- and pneumonia-related deaths. ITs were developed for the population overall and separately for children, adults, and older adults, and they were set at the upper limit of the 50% (IT50), 90% (IT90), and 98% (IT98) 1-sided confidence intervals of the geometric mean of each season's 3 highest values. Severity was classified as low if ≥2 systems peaked below IT50, moderate if ≥2 peaked between IT50 and IT90, high if ≥2 peaked between IT90 and IT98, and very high if ≥2 peaked above IT98. We pilot-tested this method with the 2015-2016 season and the 2009 pandemic. Overall, 4 seasons were classified as low severity, 7 as moderate, 2 as high, and none as very high. Among the age groups, older adults had the most seasons (n = 3) classified as high, and children were the only group to have seasons (n = 2) classified as very high. We will apply this method to classify the severity of future seasons and inform pandemic response.