The New Zealand Institute for Public Health and Forensic Science Limited (PHF Science), formerly the Institute of Environmental Science and Research Limited (ESR), is launching the sixth phase of its globally recognised Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) influenza research programme: SHIVERS-VI. This new phase leverages more than a decade of data to explore how people’s immune histories influence the transmission and severity of influenza and related respiratory diseases.
SHIVERS-VI will take advantage of New Zealand’s unique setting, where there was no community transmission of influenza during the 2020 and 2021 winter seasons, to understand the impact of this immunity gap on subsequent flu spread and severity.
Importantly, the study will capitalize on New Zealand’s longitudinal, high-quality and comprehensive respiratory virus surveillance and research platforms, including community and household cohorts with non-medically attended acute respiratory infections, patients seeking medical consultations and/or admitted acutely to hospital.
This becomes a strong asset to power the SHIVERS-VI study to generate more in-depth research not possible elsewhere on influenza transmission, severity and immunity impact which is crucial for improving seasonal and pandemic preparedness. It’s hoped that the findings will guide better vaccine development and more effective vaccination policies, particularly for vulnerable populations, such as the elderly, Māori, Pacific peoples, and those with chronic health conditions.
Funded with a US$7,233,895 grant from Flu Lab over four years, SHIVERS-VI will be led by PHF Science1 as part of a national and international multi-disciplinary, multi-agency collaboration. Partnering institutions include University of Otago, University of Auckland, Health New Zealand (Auckland City, Starship, Middlemore and KidzFirst Hospitals) and St. Jude Children’s Research Hospital (USA).
The project is the powerful next step in PHF Science’s long-standing leadership of influenza research, combining two major initiatives:
- SHIVERS I conducted during 2012-2017, evaluated influenza disease burden, epidemiology, virology, risk factors and immunology, along with measurement of the effectiveness of vaccination prevention strategies – funded by the US Centers for Disease Control and Prevention
- SHIVERS II-IV (also known as WellKiwis cohorts), established in 2018 to understand immune imprinting, or how a person’s first or prior flu exposures to flu viruses shape their immune responses to subsequent flu exposures – funded by the US National Institute of Allergy and Infectious Diseases (NIAID).
By integrating data across both platforms, SHIVERS-VI will seek to provide a comprehensive picture of influenza risk, illness progression and immune protection.
“New Zealand is fortunate to maintain these high-quality and comprehensive surveillance and research platforms running before, during, and after the COVID-19 pandemic. New Zealand’s absent flu circulation for two years due to COVID-19 public health and social measures created a rare and unprecedented opportunity to understand of the impact of the immunity gap on flu transmission and severity,” says Professor Sue Huang, Principal Investigator of SHIVERS.
“We’ll seek to map how immunity impacts disease outcomes, from asymptomatic infection to mild, moderate, and severe (ICU-level) illness, while also considering other factors like ethnicity, socioeconomic status, and chronic illness. The information will be valuable for better seasonal influenza control, pandemic preparedness and vaccine development,” says Professor Huang.
SHIVERS-VI will focus on four key objectives:
- Linking immune profiles with disease outcomes
Researchers will estimate true infection rates, including asymptomatic infections and mild illnesses, by tracking serological changes and PCR-confirmed respiratory illness in the community. The goal is to assess how infection rates and immune responses varied across different demographic groups before, during, and after the COVID-19 pandemic. - Mapping the full disease ‘pyramid’
PHF Science will enhance hospital surveillance in Auckland, Starship, Middlemore, and Kidz First Hospitals to capture detailed data on hospitalisations, ICU admissions and deaths in addition to sentinel general practice-based surveillance. By comparing this data with community-level infection rates, researchers will build a complete disease ‘pyramid’ to understand which groups are most at risk of mild, moderate and severe illness and why. - Comparing immune responses
In partnership with the US-based St Jude Children’s Research Hospital, researchers will assess antibody levels and cellular responses in individuals with both mild and severe influenza. This will provide crucial insight into the body’s defence mechanisms and help identify approaches to vaccine development. - Studying pathogen interactions
By analysing co-infections, such as influenza combined with RSV, SARS-CoV-2, or bacterial infections, SHIVERS-VI will investigate how pathogen interactions influence disease severity. Samples will undergo PCR testing for 11 common respiratory viruses, and a subset will be sequenced using metagenomics for in-depth pathogen profiling.
ENDS
Additional information:
Why New Zealand?
As an island country, New Zealand’s setting is excellent for conducting natural experiments. The unique COVID-19 elimination strategy and implementation resulted in no influenza circulation in New Zealand for two years. In addition, New Zealand’s integrated, publicly funded health system and unique population identifiers allow for long-term tracking of health outcomes across demographic groups. Māori and Pacific communities, who bear a disproportionate burden of respiratory illness, will be a central focus of this study.
Global impact
SHIVERS-VI’s findings will have international relevance, contributing to global influenza preparedness and response, including vaccine design, surveillance infrastructure, and policy development. As the Southern Hemisphere often predicts Northern Hemisphere trends, New Zealand’s data will help shape early global responses to emerging influenza threats.
[1] The research is funded through ESR Charitable Solutions Limited, a wholly owned subsidiary of the New Zealand Institute for Public Health and Forensic Science Limited.