Respiratory Virus Dashboard

Includes the data used to make the Respiratory Virus Dashboard. Data are in long format to show the data at the regional (using the Regional Public Health Office regions (https://www.cdph.ca.gov/Programs/RPHO)) and age group level (age groups included are <18, <5, 5-17, 18-64, >65 years). Data include vaccine coverage and cumulative doses, test positivity, flu typing, emergency department (ED) visits, hospital admission, deaths, and pediatric deaths. Weekly data are defined as Sunday through Saturday. Vaccine coverage estimates are produced by using available immunization information system (IIS) data from The California Immunization Registry (CAIR) and National Immunization Survey (NIS) data from CDC. NIS data is only available at the state level; to calculate regional vaccine coverage estimates based on historical ratios of IIS:NIS from past seasons, IIS-based coverage estimates are rescaled for regions. IIS:NIS ratios are calculated at the state level independently by vaccine type, season, and age group. Adjustments are made using in-season available data or the most recent available NIS estimates and reconciled as needed to match statewide estimates so that overall adjusted estimates match NIS state-wide coverage in aggregate. If NIS data is not available at the state level, analogous national level vaccine coverage estimates are used to calculate the IIS:NIS ratio. CAIR is a secure, confidential, statewide database that tracks and stores vaccination records for California residents. CAIR vaccination data likely underestimate true vaccination rates; although reporting became required by California law in January 2023 and the quality of CAIR data continues to improve over time, patient records may be incomplete or missing. Data completeness can vary by factors such as age, type of vaccination, region, provider reporting practices, historical record gaps, and population movement. Flu vaccine administration data resets on the first day of the new respiratory virus season. COVID vaccine administration data resets when the new product is FDA approved and available. Test positivity data on this dashboard may differ from local dashboards due to differing data sources. Lab data for COVID-19, influenza, and RSV test results for California residents are sent to California Department of Public Health (CDPH) through electronic laboratory reporting via CalREDIE (https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/CalREDIE.aspx). Test positivity is based on test results with a specimen collection date reported during a given week. Test positivity is calculated as the number of positive Nucleic Acid Amplification Test (NAAT) results divided by the total number of tests done. Flu typing data uses the same electronic lab reporting as the Influenza test positivity data. In the dashboard we display these data as counts of positive tests for Flu A and Flu B. ED visits data are available through CDC from the National Syndromic Surveillance Program (NSSP). ED visits are displayed as percent of ED visits which uses the number of ED visits with symptoms attributed to the selected condition for that week divided by the total number of ED visits for that week. For more information on NSSP data including data collection information see the CDC NSSP webpage (https://www.cdc.gov/nssp/php/about/index.html). Syndromic surveillance is meant to supplement, not replace, other forms of public health surveillance. Efforts to improve widespread adoption of syndromic surveillance data collection throughout the state are ongoing. Caution is advised when incorporating these data in analyses, as the data may not be representative of every region or community in California. For more information on CDPH’s syndromic surveillance program, visit the CDPH CalSyS webpage (https://www.cdph.ca.gov/Programs/CID/OIDPR/Pages/Syndromic-Surveillance/About-CalSyS.aspx). Laboratory-confirmed COVID-19, influenza, and RSV hospital admissions are required to be reported through the National Healthcare Safety Network (NHSN). The requirement to report COVID-19, influenza, and RSV-associated hospitalizations was effective November 1, 2024, therefore we only show hospitalization data by age and in total for influenza and RSV data after November 1, 2024. As COVID-19 hospitalization data reporting was required by age and in total prior to May 2024, we show hospitalization data for COVID-19 for all three seasons and have imputed modeled data from May-October 2024. For more information on NHSN data including the protocol and data collection information, see the CDC NHSN webpage (https://www.cdc.gov/nhsn/index.html). CDPH pulls NHSN data from the Centers for Disease Control and Prevention (CDC) on the Thursday prior to the update of the dashboard. Results may differ depending on which day data are pulled. Admission rates are calculated using population estimates from the P-3: Complete State and County Projections Dataset (https://dof.ca.gov/forecasting/demographics/projections/) provided by the State of California Department of Finance. Reported weekly admission rates for the entire season use the population estimates for the year the season started. COVID-19, influenza, and RSV death data come from CDPH’s Comprehensive Death File. These death counts do not always mean that COVID-19, influenza, or RSV deaths were confirmed by a laboratory. California counts deaths from COVID-19, influenza, and RSV for residents if the death certificate mentions any of these illnesses. Since 2023, COVID-19 pediatric deaths that have been identified from the CDPH Comprehensive death file are matched to a PCR test within 30 days prior to death. Starting with the 2026/2027 season, COVID-19 pediatric deaths are required to meet clinical criteria and have laboratory evidence for COVID-19 using the criteria outlined in the Council of State and Territorial Epidemiologists (CSTE) definition (https://cdn.ymaws.com/www.cste.org/resource/resmgr/position_statements_files_2023/ps_updates/25-ID-03_COVID-19_Associated.pdf). Seasons prior to 2026/2027 will continue to use the prior definition. Providers must report influenza-related deaths in children under 18. This is required by California law (Title 17, Section 2500 of the California Code of Regulations (PDF) (https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/ReportableDiseases.pdf)). These pediatric deaths also require lab confirmation. Providers must report RSV-related deaths in children under 5. This is required by California law (Title 17, Section 2500 of the California Code of Regulations (PDF) (https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/ReportableDiseases.pdf)). These pediatric deaths also require lab confirmation.

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