{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T06:28:59Z","timestamp":1777357739193,"version":"3.51.4"},"reference-count":32,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>While severe outcomes among hospitalized patients with COVID-19 and influenza are well described, comparative studies are lacking on community transmission and milder illnesses associated with COVID-19 and influenza.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study is based on a prospective community cohort in Wellington, New Zealand, consisting of participants with acute respiratory illness associated with COVID-19 and influenza, as confirmed by polymerase chain reaction. From 7 February to 2 October 2022, we compared the incidence, risk\/protective factors, and clinical features among them.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The crude incidence of COVID-19\u2013associated acute respiratory illness was 59 per 100 person-years (PY). The adjusted cumulative incidence for COVID-19 (77\/100 PY; 95% CI, 75\u201380) was 4.5 times higher than for influenza (17\/100 PY; 95% CI, 15\u201319). Among all COVID-19 cases, the proportion of children aged 0 to 17 years with COVID-19 was substantial but smaller than those of influenza (402\/1229 [33%] vs 173\/255 [68%], P &amp;lt; .0001). The highest incidence of COVID-19 was among adolescents aged 12 to 17 years (109\/100 PY; 95% CI, 97\u2013119) and individuals who were European and other ethnicity (83\/100 PY; 95% CI, 80\u201386), whereas the highest influenza incidence was among children aged 1 to 4 years (49\/100 PY; 95% CI, 40\u201358) and M\u0101ori (35\/100 PY; 95% CI, 28\u201343). Adolescents aged 12 to 17 years had 2.5-times higher peak COVID-19 incidence (5.9\/100) than adults aged \u226518 years (2.4\/100). Adolescents with 2 doses of the COVID-19 vaccines had 75% greater risk of COVID-19 infection (hazard ratio, 1.75; 95% CI, 1.40\u20132.20) as compared with adults with 3 doses. Vaccination, age, ethnicity, and household size were independent protective\/risk factors for COVID-19 or influenza. Participants with COVID-19, as compared with influenza, were less likely to access health care or experience febrile and severe illnesses but more likely to report sore throat, headache, myalgia, and taste or smell loss.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>As the world transitions to COVID-19 endemicity, estimating disease burdens in community settings becomes important to understand complete disease pyramids, risk factors, and clinical progression for informing countermeasures.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf097","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T03:22:06Z","timestamp":1740453726000},"source":"Crossref","is-referenced-by-count":2,"title":["Comparison of the Incidence and Risk Factors of Acute Respiratory Illness Associated With COVID-19 and Influenza: Results of the SHIVERS II, III, and IV Prospective Community Cohort Study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3923-5195","authenticated-orcid":false,"given":"Q Sue","family":"Huang","sequence":"first","affiliation":[{"name":"Institute of Environmental Science and Research , Wellington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Wood","sequence":"additional","affiliation":[{"name":"Institute of Environmental Science and Research , Wellington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nayyereh","family":"Aminisani","sequence":"additional","affiliation":[{"name":"Institute of Environmental Science and Research , Wellington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4184-001X","authenticated-orcid":false,"given":"Amanda","family":"Kvalsvig","sequence":"additional","affiliation":[{"name":"University of Otago , Wellington and Dunedin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1865-1536","authenticated-orcid":false,"given":"Michael G","family":"Baker","sequence":"additional","affiliation":[{"name":"University of Otago , Wellington and Dunedin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0078-4549","authenticated-orcid":false,"given":"Nhung","family":"Nghiem","sequence":"additional","affiliation":[{"name":"University of Otago , Wellington and Dunedin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Seeds","sequence":"additional","affiliation":[{"name":"Institute of Environmental Science and Research , Wellington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tineke","family":"Jennings","sequence":"additional","affiliation":[{"name":"Regional Public Health, Te Whatu Ora\u2013Health New Zealand Capital, Coast and Hutt Valley , Wellington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5993-6266","authenticated-orcid":false,"given":"Lauren","family":"Jelley","sequence":"additional","affiliation":[{"name":"Institute of Environmental Science and Research , Wellington"},{"name":"University of Otago , Wellington and Dunedin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chor Ee","family":"Tan","sequence":"additional","affiliation":[{"name":"Institute of Environmental Science and Research , Wellington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meaghan","family":"O\u2019Neill","sequence":"additional","affiliation":[{"name":"Institute of Environmental Science and Research , Wellington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srushti","family":"Utekar","sequence":"additional","affiliation":[{"name":"Institute of Environmental Science and Research , Wellington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0970-0153","authenticated-orcid":false,"given":"Jemma L","family":"Geoghegan","sequence":"additional","affiliation":[{"name":"Institute of Environmental Science and Research , Wellington"},{"name":"University of Otago , Wellington and Dunedin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Winter","sequence":"additional","affiliation":[{"name":"Institute of Environmental Science and Research , Wellington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikki","family":"Turner","sequence":"additional","affiliation":[{"name":"University of Auckland , Auckland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tony","family":"Dowell","sequence":"additional","affiliation":[{"name":"University of Otago , Wellington and Dunedin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Balm","sequence":"additional","affiliation":[{"name":"Te Whatu Ora\u2013Health New Zealand Capital, Coast and Hutt Valley , Wellington ,","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron C","family":"Grant","sequence":"additional","affiliation":[{"name":"University of Auckland , Auckland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette","family":"Nesdale","sequence":"additional","affiliation":[{"name":"Regional Public Health, Te Whatu Ora\u2013Health New Zealand Capital, Coast and Hutt Valley , Wellington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hazel C","family":"Dobinson","sequence":"additional","affiliation":[{"name":"Te Whatu Ora\u2013Health New Zealand Capital, Coast and Hutt Valley , Wellington ,","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Daniells","sequence":"additional","affiliation":[{"name":"Te Whatu Ora\u2013Health New Zealand Capital, Coast and Hutt Valley , Wellington ,","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"McIntyre","sequence":"additional","affiliation":[{"name":"University of Otago , Wellington and Dunedin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0682-6933","authenticated-orcid":false,"given":"Marc-Alain","family":"Widdowson","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Europe , Copenhagen ,","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7955-0256","authenticated-orcid":false,"given":"Paul G","family":"Thomas","sequence":"additional","affiliation":[{"name":"World Health Organization 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