Context:
Newspapers on March 7-8, 2025 reported a 54% spike in influenza cases in the Delhi-NCR region. The reports were based on a LocalCircle survey of 13,000 people, focused on viral illness symptoms and not clinical testing. Despite the survey mentioning “viral illnesses (Covid/flu/viral fever),” reports attributed the spike primarily to influenza.
Official Data on Influenza Cases
- As per NCDC’s IDSP data (Feb 27, 2025)
- 516 influenza cases and 6 deaths in January 2025.
- In 2024, India reported 20,414 flu cases with 347 deaths.
- Lack of segregated monthly historical data makes year-on-year comparisons difficult.
- Flu cases in India typically peak during monsoon and see a secondary peak in winter.
Burden of Influenza in India
- Influenza causes substantial illness and deaths annually.
- Surveillance between 2016–2018 showed:
- 15.4% of ARI cases and 12.7% of SARI cases were due to influenza.
- Estimating deaths is challenging due to limited clinical testing and low certification of influenza as a cause of death.
- A 2020 study estimated 1,27,092 influenza-related deaths annually in India, with high mortality among those over 65 and children under five.
Vaccination Recommendations and Challenges
- India’s Health Ministry (2018 guidelines):
- Vaccine “recommended” for pregnant women, children, and adults with chronic illnesses.
- Only considered “desirable” for adults over 65 and children under five, despite high mortality in these groups.
- WHO recommendations for 2025–26 flu vaccine composition were announced on Feb 28, 2025, giving manufacturers time to prepare.
- Most vaccines in India, including those from Serum Institute, are egg-based.
Vaccine Uptake: Global vs India
- In the U.S., as of Feb 15, 2025:
- 57 million adults and 47% of children had been vaccinated.
- In India, vaccine uptake remains below 5%:
- A 2022 study found only 1.5% of adults aged 45+ had ever been vaccinated.
- Despite severe outbreaks in 2015, 2017, 2019, and 2024, uptake remains stagnant.
Current Market Trends and Production Capacity
- Sanofi spokesperson: Flu vaccine market in India grew 21% in 2025 vs 2024.
- Serum Institute produces 3–4 lakh doses, scalable to 1 million based on demand.
Key Takeaways
- Influenza continues to be a major public health threat in India with underreported and underestimated mortality.
- Low vaccination coverage is attributed to lack of awareness, limited clinical diagnosis, and absence of inclusion in the universal immunisation programme.
- Experts emphasize the need for increased public health campaigns, healthcare worker immunization, and targeted vaccination for vulnerable groups.
