Understanding the SHIVERS Influenza Research Programme

The Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance, known as SHIVERS, represents a cornerstone of modern virology and public health research in New Zealand. Launched in 2012, this ambitious programme has evolved through multiple phases, amassing over 15 years of data on influenza and other respiratory viruses. Hosted primarily at PHF Science in Auckland, SHIVERS integrates hospital-based surveillance, community cohort studies, and advanced genomic analysis to capture the full spectrum of respiratory disease—from mild community cases to severe hospitalizations and even mortality.

What sets SHIVERS apart is its population-based approach, covering hundreds of thousands of residents in Auckland and later Wellington regions. By swabbing patients, analyzing blood for antibodies, and tracking symptoms via online surveys, researchers have painted a comprehensive picture of how viruses like influenza A(H1N1), A(H3N2), B strains, respiratory syncytial virus (RSV), and even SARS-CoV-2 spread and impact communities. This data has not only informed New Zealand's health policies but has rippled across the globe, influencing World Health Organization (WHO) guidelines and vaccine development strategies.

In the context of higher education, SHIVERS exemplifies collaborative research excellence, drawing expertise from institutions like the University of Auckland and University of Otago. For aspiring researchers, it highlights career pathways in epidemiology, immunology, and infectious disease surveillance—fields where demand for skilled professionals remains high amid ongoing pandemic threats.

Origins and Phases of the SHIVERS Programme

SHIVERS originated in response to the 2009 H1N1 pandemic, which exposed gaps in southern hemisphere influenza monitoring. Funded initially by the US Centers for Disease Control and Prevention (CDC) with New Zealand Ministry of Health support, the first phase (SHIVERS-I, 2012-2017) focused on Auckland's two major district health boards, encompassing 906,000 residents. This phase established dual surveillance platforms: one for severe acute respiratory illness (SARI) in hospitals like Auckland City and Middlemore, and another for influenza-like illness (ILI) in sentinel general practices.

Subsequent phases expanded geographically and methodologically:

• SHIVERS-II (WellKiwis Adult, 2018-2028): Recruited 997 adults in Wellington for longitudinal tracking of immune responses.
• SHIVERS-III (WellKiwis Infant, 2019-2026): Enrolled 691 infants to study early-life exposures.
• SHIVERS-IV (WellKiwis Household, 2019-2028): Monitored 1,714 individuals across 496 households to map intra-family transmission.
• SHIVERS-V (2022-2024): Analyzed COVID-19 border closures' effects on respiratory viruses.
• SHIVERS-VI (2025-2029): Secured US$7.2 million (NZ$12 million) from Flu Lab, leveraging prior data to probe immunity gaps from New Zealand's 2020-2021 influenza hiatus.

To date, the programme has garnered over NZ$62 million in international funding, underscoring its global value. Each phase builds on serological surveys, real-time PCR testing for multiple pathogens, and economic burden analyses, providing step-by-step insights into virus evolution, vaccine performance, and intervention efficacy.

Innovative Methods Driving SHIVERS Success

SHIVERS employs a multi-layered methodology to ensure robust, unbiased data. Hospital surveillance captures SARI cases through daily swabbing of nasopharyngeal samples, tested for influenza subtypes, RSV, rhinovirus, parainfluenza, adenovirus, and human metapneumovirus. Community arms use sentinel GPs and self-reporting apps, where participants submit weekly symptom logs during flu season and provide swabs upon ILI onset.

Immunological depth comes from pre- and post-season blood draws, measuring anti-hemagglutinin (HA) and anti-neuraminidase (NA) antibodies, T-cell responses, and cytokine profiles. Household cohorts intensify monitoring: once a flu case is confirmed, every family member is swabbed every three days to trace secondary attacks. This granular approach—combining epidemiology, virology, and immunology—has yielded attack rates, risk factors (e.g., young children, Māori/Pacific peoples), and co-infection patterns previously elusive in passive surveillance systems.

For researchers in New Zealand universities, these methods offer hands-on training in cohort design, genomic sequencing, and data analytics, fostering skills transferable to higher education research jobs.

1. Championing Free Flu Vaccines for High-Risk Children

One of SHIVERS' earliest triumphs came from SHIVERS-I data revealing alarmingly high influenza hospitalization rates among children under five—especially those with prior respiratory issues—coupled with vaccination coverage below 5%. In 2013, this evidence prompted New Zealand to extend free seasonal influenza vaccines to this group, a policy shift preventing thousands of admissions annually.

Step-by-step, the process unfolded: surveillance identified the burden (e.g., 20-30% of pediatric SARI cases influenza-linked), economic analyses quantified costs, and risk factor studies pinpointed vulnerabilities like overcrowding in Māori communities. Today, uptake has risen, reducing equity gaps and serving as a model for targeted immunization worldwide.

2. Aligning Global Influenza Surveillance Standards

SHIVERS-I uncovered that influenza PCR positivity persisted 8-9 days post-symptom onset, challenging the WHO's 7-day SARI definition. Advocating with high-quality Auckland data, researchers influenced a 2014 revision to 10 days, standardizing surveillance across 194 countries. This enabled accurate hospitalization rate comparisons, vital for tracking pandemics like H1N1.

The impact? Enhanced global data comparability, better vaccine strain forecasting, and improved southern hemisphere contributions to northern decisions—critical since flu peaks there first.

3. Shaping WHO's Pandemic Severity Framework

Leveraging comprehensive metrics on transmissibility, clinical severity, and healthcare strain, SHIVERS data helped forge the WHO Pandemic Influenza Severity Assessment framework. This tool guides responses by categorizing threats (e.g., mild vs. severe), informing lockdowns, vaccine prioritization, and resource allocation.

In practice, during COVID-19, similar indicators from SHIVERS-V validated New Zealand's elimination strategy, showcasing real-world applicability.

Photo by Guido Hofmann on Unsplash

4. Building New Zealand's National Respiratory Surveillance Platform

SHIVERS-I birthed a enduring infrastructure: weekly ILI reports to the Ministry of Health, genomic dashboards for real-time strain tracking (e.g., H5 avian flu), and integrated platforms now covering COVID-19 wastewater monitoring. Shared internationally, this bolsters policy-making and rapid response.

Statistics highlight scale: over 100,000 GP consultations and 1 million hospital catchments monitored, yielding actionable insights like seasonal peaks.

5. Paving the Way for Universal Flu Vaccines

A 2015 SHIVERS serosurvey revealed unexpectedly high anti-NA antibodies—outpacing anti-HA—flipping assumptions about flu immunity. NA's conservation across strains positions it for 'universal' vaccines offering multi-year protection, unlike annual HA-focused shots. US trials now build on this, promising reduced mismatch issues.

For research assistant jobs in immunology at NZ universities, such discoveries underscore cutting-edge opportunities.

6. Proving Efficacy of Public Health Measures

Pre-COVID WellKiwis data established baselines; post-border closure, influenza and RSV vanished for two years (2020-2021). This natural experiment quantified non-pharmaceutical interventions' power: masks, distancing, and quarantines slashed transmission by over 99% for respiratory viruses.

Stakeholder perspectives—from GPs to iwi leaders—emphasized cultural tailoring, like community-led contact tracing, enhancing trust and compliance.

7. Demonstrating COVID-19 Vaccine Transmission Reduction

SHIVERS cohorts evaluated New Zealand's rollout: vaccinated individuals showed 40-60% lower community transmission, informing equity-focused boosters for high-risk groups. This evidence shaped communication, countering hesitancy and optimizing future campaigns.

SHIVERS' Ties to New Zealand Higher Education

Universities are integral: The University of Auckland leads SHIVERS-V and secured an NZ$8.3 million Flu Lab grant for the Triple R programme, developing risk prediction tools with Otago partners. Principal investigators like Professor Nikki Turner (Immunisation Advisory Centre) and Professor Sue Huang (PHF Science) mentor PhD students and postdocs.

This fosters careers in virology; explore university jobs or academic CV tips. Recent accolades, like the 2019 Shorland Medal, affirm prestige.

Looking Ahead: SHIVERS-VI and Global Implications

SHIVERS-VI (2025-2029) dissects the 2020-2021 flu gap's immunity voids, amid 2025's extended A(H3N2) seasons. With genomic prowess for emerging threats, it positions New Zealand as a sentinel. Actionable insights: bolster longitudinal cohorts, integrate AI for forecasting, and prioritize equity.

For professionals, check postdoc opportunities or NZ academic jobs.

Photo by Etactics Inc on Unsplash

Why SHIVERS Matters for Future Researchers

Amid climate shifts prolonging seasons and antimicrobial resistance rising, SHIVERS equips the next generation. Share experiences on Rate My Professor, pursue higher ed jobs, or seek career advice. Its legacy: data-driven health security worldwide.