There is a critical need for Influenza forecasting among public health decision makers, large organizations, healthcare participants, and the general public. We focus in this proposal on the first and last categories. For federal and state officials, influenza forecasting can help inform the timing of critical communications, vaccination campaigns, messaging to state and local public health agencies, hospitals, healthcare professionals, and the public. During flu pandemics, forecasting can inform the formulation and execution of strategies for vaccine development, vaccine distribution and (application), dissemination of antivirals, and recommendations for non-pharmaceutical interventions. Further, public health communications to healthcare providers can result in more informed doctors’ decisions regarding use of antibiotics and hospitalization. For the general public, reliable short term forecasts can increase the credibility of and trust in pubic health authorities, resulting in greater adherence to recommendations. Short term forecasts can also inform individuals’ decision making, especially with regard to behavior and exposure of flu-vulnerable populations: the elderly, the very young, the pregnant and the immunocompromised. Members of these groups may reconsider their travel plans and other public exposure if warned in advance of an impending epidemic wave at a specific location. While such decisions might also be informed by existing flu surveillance, inherent latencies in traditional surveillance means that nowcasting and short-term forecasting provide a few weeks advance notice -- enough to save many lives. To advance the state of the art in influenza forecasting, we propose an Influenza Forecasting Center of Excellent that will enable and improve the usefulness of forecasts of both seasonal influenza and pandemic influenza, to inform public health responses and policy development at the national, regional, and state level. The center will (1) review and, if needed, revise existing forecasting guidance, targets, and accuracy evaluation, at the national, regional, and state levels; (2) refine methods to create forecast ensembles; (3) identify methodologies and data sources that increase forecast accuracy for start and peak week forecasts, peak intensity, and short-term forecasts at the national, regional, and state level; (4) develop communication products and data visualization methods to describe forecast results and uncertainty for federal and state public health officials and the public; and (5) develop and adapt successful seasonal methodologies, data sources, and communication approaches for forecasting the timing, intensity, and short-term trajectory of an emerging influenza pandemic.


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