Investigating Respiratory Viruses in the Acutely Ill (IVY) Network

What to know

The Investigating Respiratory Viruses in the Acutely Ill (IVY) network is an influenza (flu), COVID-19, and respiratory syncytial virus (RSV) vaccine effectiveness network that currently consists of 26 medical centers in 20 U.S. states. Prior to December 2022, the network was known as the "Influenza and Other Viruses in the Acutely Ill network." IVY was created in 2019 to estimate how well flu vaccines work to prevent severe flu illness among intensive care unit (ICU) patients. Since then, the network has expanded to also assess how well flu, COVID-19, and RSV vaccines work to prevent hospitalizations associated with influenza, SARS-CoV-2 (the virus that causes COVID-19) and RSV viruses, respectively. In 2024, patients hospitalized with human metapneumovirus (hMPV) were added to begin monitoring hMPV disease among hospitalized adults; there are no licensed vaccines to protect against hMPV.

Close-up of multiple vaccine vials

Flu Vaccine Effectiveness

Measuring vaccine effectiveness (VE) in hospitalized adults is important to better understand how well flu vaccines protect against hospitalizations and ICU admissions.

VE among adults 65 years and older is especially important because this group of people has the highest flu-associated hospitalization rates compared with other age groups.

CDC measures VE to evaluate the benefits of flu vaccines in different age groups and against different clinical outcomes, such as hospitalization or ICU admission. These efforts help convey the importance and impact of flu vaccination.

Sites and Study Design

26 participating sites are located in 20 U.S. states

  • Baylor Scott & White Medical Center (Texas)
  • Baylor University Medical Center (Texas)
  • Baystate Medical Center (Massachusetts)
  • Beth Israel Deaconess Medical Center (Massachusetts)
  • Cleveland Clinic (Ohio)
  • Emory University Medical Center (Georgia)
  • Hennepin County Medical Center (Minnesota)
  • Henry Ford Health (Michigan)
  • Intermountain Medical Center (Utah)
  • Johns Hopkins Hospital (Maryland)
  • Montefiore Medical Center (New York)
  • The Ohio State University Wexner Medical Center (Ohio)
  • Oregon Health & Science University Hospital (Oregon)
  • Stanford University Medical Center (California)
  • UCLA Medical Center (California)
  • University of Colorado Hospital (Colorado)
  • University of Iowa Hospitals (Iowa)
  • University of Miami Medical Center (Florida)
  • University of Michigan Hospital (Michigan)
  • University of Utah (Utah)
  • University of Washington (Washington)
  • Vanderbilt University Medical Center (Tennessee)
  • Wake Forest University Baptist Medical Center (North Carolina)
  • Barnes-Jewish Hospital (Missouri)
  • University of Arizona Medical Center (Arizona)
  • Yale University (Connecticut)
U.S. map showing the 26 participating sites of the IVY Network.
U.S. map showing the 26 participating sites of the IVY Network.

IVY uses a test-negative observational study design and collects data at participating hospitals.

Resources