Determinants of Influenza Mortality Trends: Age-Period-Cohort Analysis of Influenza Mortality in the United States, 1959-2016.

Despite substantial differences in the aforementioned scenarios and uncertainties regarding the true trends, some attributes of the cohort effects are common to the three sets of APC estimates: all suggest a decline in the cohort mortality trend for individuals born between 1900 and 1930 and between 1957 and 1968, as well as an increasing trend for years of birth ranging from 1947 to the mid-1950s, and from 1968 to the end of the 1970s.

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This contrast remained highly significant when moving the rupture point forward or backward by up to six years (Table S4 shows constant contrasts up to four years forward or backward), suggesting that it is not associated to one specific antigenic drift year but to a smoother and longer-term change.

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