{
  "abstract": "Influenza antivirals can directly benefit treated individuals by reducing the risk of some influenza-associated complications when initiated soon after symptom onset. Antivirals may also reduce onward transmission, and previous modeling studies including such indirect effects have estimated large population-level reductions in influenza-associated disease outcomes. However, these studies often assume an optimistic number of people initiate, and adhere to, prompt treatment. Using a compartmental framework, we modeled population-level reductions in influenza-associated hospitalizations given potential direct and indirect effects of influenza antivirals in the United States. From reported patterns of care-seeking, antiviral prescribing, and treatment adherence, we estimated 1.1-9.7% of symptomatic individuals initiate and adhere to prompt antiviral treatment. We estimated small direct effects of antivirals in example seasons, with 0.9% of hospitalizations prevented when antivirals reduced hospitalization risk by 20%. Assuming antivirals had direct and indirect effects generated slightly larger impacts. For example, up to 3.8% of hospitalizations were prevented when antivirals reduced hospitalization risk and onward transmission by 20%. More substantial impacts (for example, preventing >20% of hospitalizations) were only achieved by increasing initiation and adherence to prompt treatment beyond typically observed levels. Therefore, prompt treatment initiation and adherence are critical factors shaping potential population-level impacts of influenza antivirals.",
  "abstract_shown": true,
  "affiliations": [
    "Centers for Disease Control and Prevention"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "S. E. Morris"
    },
    {
      "name": "S. G. Dean"
    },
    {
      "name": "L. Y. H. Chan"
    },
    {
      "name": "S. Garg"
    },
    {
      "name": "T. M. Uyeki"
    },
    {
      "name": "R. K. Borchering"
    },
    {
      "name": "M. Biggerstaff"
    },
    {
      "name": "A. M. Mellis"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5vkcra9cdzezf.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.10.26362674",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.10.26362674v1.full",
  "id": "5vkcra9cdzezf",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.10.26362674v1",
  "language": null,
  "licence": "CC0-1.0",
  "licence_label": "CC0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/publicdomain/zero/1.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "epidemiology"
    ],
    [
      "openalex",
      "2713|Influenza Virus Research Studies"
    ]
  ],
  "openalex": "W7212359787",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.10.26362674v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-10",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5vkcra9cdzezf.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:23Z",
      "native_id": "10.64898/2026.09.10.26362674",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.10.26362674v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Antivirals for seasonal influenza in the US: modeling direct and indirect effects with variable uptake",
  "title_text": "Antivirals for seasonal influenza in the US: modeling direct and indirect effects with variable uptake",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:23Z",
  "url": "https://research.draconitic.com/paper/5vkcra9cdzezf",
  "venue": "medRxiv",
  "versions": []
}