BACKGROUND: The Global Influenza Hospital Surveillance Network is an international platform whose primary objective is to study severe cases of influenza requiring hospitalization. METHODS: During the 2015-2016 influenza season, 11 sites in the Global Influenza Hospital Surveillance Network in nine countries (Russian Federation, Czech Republic, Turkey, France, China, Spain, Mexico, India, and Brazil) participated in a prospective, active-surveillance, hospital-based epidemiological study. Influenza infection was confirmed by reverse transcription-polymerase chain reaction. Influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza was estimated using a test-negative approach. RESULTS: 9882 patients with laboratory results were included of which 2415 (24.4%) were positive for influenza, including 1415 (14.3%) for A(H1N1)pdm09, 235 (2.4%) for A(H3N2), 180 (1.8%) for A not subtyped, 45 (0.5%) for B/Yamagata-lineage, 532 (5.4%) for B/Victoria-lineage, and 33 (0.3%) for B not subtyped. Of included admissions, 39% were < 5 years of age and 67% had no underlying conditions. The odds of being admitted with influenza were higher among pregnant than non-pregnant women (odds ratio, 2.82 [95% confidence interval (CI), 1.90 to 4.19]). Adjusted IVE against influenza-related hospitalization was 16.3% (95% CI, 0.4 to 29.7). Among patients targeted for influenza vaccination, adjusted IVE against hospital admission with influenza was 16.2% (95% CI, - 3.6 to 32.2) overall, 23.0% (95% CI, - 3.3 to 42.6) against A(H1N1)pdm09, and - 25.6% (95% CI, - 86.3 to 15.4) against B/Victoria lineage. CONCLUSIONS: The 2015-2016 influenza season was dominated by A(H1N1)pdm09 and B/Victoria-lineage. Hospitalization with influenza often occurred in healthy and young individuals, and pregnant women were at increased risk of influenza-related hospitalization. Influenza vaccines provided low to moderate protection against hospitalization with influenza and no protection against the predominant circulating B lineage, highlighting the need for more effective and broader influenza vaccines.

Department of Internal and Pulmonary Medicine Sher i Kashmir Institute of Medical Sciences Soura Bemina Srinagar Jammu and Kashmir 190011 India

FIOCRUZ Rio de Janeiro Brazil

Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana FISABIO Valencia Spain

INSERM F CRIN Réseau National d'Investigation Clinique en Vaccinologie CIC Cochin Pasteur Paris France and Université Paris Descartes Sorbonne Paris Cité and Assistance Publique Hôpitaux de Paris Hôpital Cochin Paris France

Ivanovsky Institute of Virology FSBI N F Gamaleya NRCEM Ministry of Health Moscow Russian Federation

National Institute of Public Health Prague Czech Republic

Research Institute of Influenza WHO National Influenza Centre of Russia and Ministry of Healthcare of the Russian Federation St Petersburg Russian Federation

Salvador Zubirán National Institute of Medical Sciences and Nutrition Vasco de Quiroga 15 Belisario Domínguez Sección 16 14080 Tlalpan CDMX Mexico

School of Public Health Li Ka Shing Faculty of Medicine Hong Kong Hong Kong Special Administrative Region of China

Turkish Society of Internal Medicine Ankara Turkey

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The Global Influenza Hospital Surveillance Network: A Multicountry Public Health Collaboration