Influenza-Related Mortality

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Abstract
ALBERT Sabin, MD,1in an article published inJAMAtakes issue with estimates of influenza-related mortality published by the Center for Disease Control (CDC) and current recommendations for yearly influenza immunization of persons assumed to be at high risk of dying from influenza. Sabin's conclusions are based on analyses of recent morbidity and mortality data published by CDC and the National Center for Health Statistics (NCHS). We believe the methods Sabin used in his analyses obscure important epidemiologic features of influenza and, hence, lead him to draw incomplete and erroneous conclusions regarding the impact of influenza in the United States and thebenefits of annual influenza immunization of those at high risk. Sabin's Analytic Methods Three aspects of Sabin's analytic methods are inappropriate to a thorough understanding of influenza epidemiology and its relationship to epidemic-associated mortality. These include (1) use of the calendar year rather than an epidemiologic year as

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