In 1960, the U.S. Surgeon General, in response to substantial morbidity and mortality during the 1957-58 pandemic, recommends annual influenza vaccination for people with chronic debilitating disease, people aged 65 years or older, and pregnant women.

During the 1957 pandemic, an estimated 1.1 million people died worldwide, including 116,000 people in the U.S. Some experts commented that, should a new influenza virus emerge in the U.S. or emerge as manufacturers were producing seasonal influenza vaccine, a pandemic vaccine would not be available in time to provide significant protection for Americans.

After the pandemic, Surgeon General Leroy Burney suggested that the U.S. could be better prepared. He recommended the development of new strategies to quickly produce pandemic vaccine. He also recognized the need to increase technical training, augment supply of diagnostic materials to collaborating laboratories, and quickly complete antigenic studies of new influenza viruses to improve Centers for Disease Control and Prevention’s (CDC) influenza surveillance capabilities.