Thank you, Fiona.
Thank you, Fiona. Good evening, everyone, and good morning to those online. It's great to see everyone here in the beautiful city of Chicago. I ran into Paul in the elevator. I was surprised how great the weather is here. But I know many of you traveled a long distance to be with us here today, and we certainly appreciate that, and we want to acknowledge that because we know that journey is particularly a long one. We look forward to the opportunity to bring you closer to the CSL journey and our leadership team that I have here with me during the meeting as we explain our plans for the future. I thought I would just take a minute to talk about where we're sitting, the hotel that we're at.
It dates back to the 1920s, and actually, the hotel was built at the same time as a children's hospital. The children's hospital is called Shriners Hospitals for Children, which has turned into a large network of children's hospitals throughout the U.S., in particular, that serves terminally ill children and supports their families. I always find a little bit of history interesting to reflect upon, a healthcare history for the Shriners and the area. We will open our event this week with a real focus on CSL Seqirus, and in a minute, I will have the pleasure to welcome Dave Ross to the stage to give you an overview of that business. We understand there's going to be questions about the outlook for this part of the business. Given the current market dynamics and our recent announcements, we look forward to delving into those very specific questions that you have.
We also know you're keenly interested in the core business of plasma and its future, and we intend to spend the majority of tomorrow discussing the core business and really getting into what that looks like now and in the future. So it's my pleasure to welcome Dave to the stage for a look inside CSL Seqirus. Dave will be joined on the stage after his presentation by Ken Lim, our newly appointed Chief Financial Officer, and myself for Q&A. Dave.
All right, thanks, Paul, for that introduction, and good evening, everybody. You know, CSL Seqirus has been on an incredible journey of growth and market leadership since its inception 10 years ago. And I know that there are some current headwinds that we need to work through, but we need to put those things into proper context. Our business. Our strategy, and our prospects for growth are very promising. So with that in mind, let me start by sharing with you the three things I'd like you to take away from our discussion this evening. The first is that influenza is a uniquely complex pathogen amongst the vaccine-preventable diseases. And in that complexity brings opportunities for strategic differentiation. The second thing is that while there are near-term headwinds, we're confident that we will see a market recovery in the U.S. in the medium term.
And the last and most important thing is how Seqirus is uniquely positioned to create value and outperform the market. Now, before I jump into the meat of the discussion, let me give you a brief introduction to Seqirus and what sets us apart from the competition. Our incredible journey of growth and leadership is owed to our differentiation strategy that's built on the balance of having the right vaccine technologies, a unique set of strategic capabilities, and by creating the right customer experience for our healthcare providers that we serve. I am extremely proud of the Seqirus team and how we've created enduring competitive advantage in a very unique part of the vaccine marketplace. This is essentially a just-in-time business for a complex and changing biological product that operates in extreme seasonality. Now, what that strategy has gotten us to date is the following.
What you're looking at here is our revenue share in red versus our two primary competitors from 2017 when we first executed our differentiation strategy. It shows consistent share growth year- over- year, which was generated through increased volume and by driving value through improved product and customer mix. It's everything that you'd expect from a well-designed and executed differentiation strategy. Now, to fully appreciate the value of our business. You need to understand w hat the underlying public health need is that it serves. And as the public health and economic stats on this slide make very clear, influenza is not the common cold. It's far from it. This is especially true for the most vulnerable of our populations for whom the consequences could be devastating. It's the high cost of this disease that fundamentally underpins the long-term value and viability of the influenza vaccine market.
And it's also the reason there are well-structured immunization programs in all major markets. So let's take a look first at the demand in the biggest markets outside of the U.S. In all of these markets, immunization rates peaked during the COVID pandemic when flu vaccines were used as a critical tool to protect the health system capacity that was needed to care for COVID patients. Since then, the rates in all of these markets have returned to and stabilized at pre-pandemic levels of between 40% and 70%. The real challenge that we're facing is within the U.S. market, where vaccine hesitancy has led to a significant decline in immunization rates. So, like in the other markets, we saw immunization rates peak in the U.S. the first year of that COVID pandemic. However, unlike the other markets, the U.S.
is experiencing significant vaccine fatigue that's led to a decline in immunization rate levels far below what was routine prior to the pandemic. Now, this immunization rate decline equates to about 60 million fewer people being immunized each year. This is, quite honestly, a staggering number from a public health perspective, one that will not go without real consequences and costs from a public health perspective. In fact, when you overlay the hospitalization trends, what you see is a clear correlation between the reduced immunization rates and the higher disease burden. This past flu season represented the worst influenza season in the past 15 years. So what we know is that disease is rising while immunization rates are declining. What we don't know yet is when that rising burden of disease will trigger the change in behavior that's needed to see immunization rates recover.
In the end, we feel very strongly that science and data will prevail and the public health consequences will ultimately be too big to ignore. Now, in times like this, history can often give us a useful perspective. So on my next slide, I'm going to take you back to a period of about 2005 and 2010 when there was a significant vaccine hesitancy across the vaccine marketplace, including influenza. Now, during this period, immunization rates were hit with three challenges. There were behavioral challenges where there was significant mis- and disinformation that led to an anti-vax movement, which in turn led to low confidence in vaccines. There were structural challenges that limited access for patients to immunization. And there were industrial challenges that resulted in unreliable supply. But what happened was that the stakeholders across the vaccine market leaned in to solve for these challenges.
They were all driven by the common view and understanding that the public health consequences of the approach at that time were resulting in cost and disease burden that was simply too high. So following their collective effort, we saw a nearly doubling of doses administered in the U.S. in the decade and a half that followed. And at that same time, we saw the market value of influenza vaccine grow by nearly fivefold due to the launch of higher-valued differentiated vaccines. In the headwinds we're currently facing, we don't see the structural or industrial challenges that we faced at that time. What we're experiencing are the behavioral challenges caused by this mis- and disinformation regarding vaccine safety and effectiveness. And like with the last period of vaccine hesitancy, we believe that the science and the data will drive a similar response from stakeholders to take action.
Now, in fact, we're beginning to see stakeholders mobilize. We're seeing patient advocacy groups that are implementing more and broader educational and awareness programs. We're seeing medical societies and newly formed advisory groups taking steps to preserve and promote evidence-based decision-making. And insurers have confirmed their coverage of vaccines based upon their inherent health economic benefits. And to support these efforts, Seqirus will continue to gather compelling evidence on the benefits of our vaccine, which will do two things. It will help healthcare providers make informed clinical decisions for their patients a nd should help improve public confidence in vaccines. Now, while immunization rate recovery is important to the growth of our business and the overall market, it's only one part of our growth story. So let me explain what I mean by that.
Influenza is a very complex virus, and in that complexity are opportunities to create strategic differentiation in ways that healthcare providers will value. Flu is one of the most highly variable pathogens for which we immunize. There are multiple circulating strains that are continuously evolving, drifting and shifting so that the attack rates and the virulence could vary from season to season. And the at-risk populations can also vary from year to year. It's a highly seasonal viral activity with two prominent disease seasons, one in the northern and one in the southern hemisphere. The viral complexity creates a need for a very specialized capability, especially to participate in the higher-value enhanced vaccine space we occupy. Now, add to this the operational challenges of having to reformulate the vaccine every year to match the circulating strains. It's essentially like launching a new product every year.
And this requires a very different kind of manufacturing excellence and agility. There are also unique supply chain challenges as the vaccines are released on a rolling basis during the immunization season, all without the traditional safety stocks that you'd see with other vaccines. And then there's the fact that our customers, the healthcare providers, execute about 95% of all of their immunizations for flu over a short 12-week period. Now, when you combine all of this complexity, it's essentially a just-in-time business for a very complex biological product that operates, as I said, on an extreme seasonality. At Seqirus, we welcome each of these challenges as opportunities to differentiate Seqirus in ways that create value to the healthcare providers we serve. In fact, we take a very holistic approach to our differentiation strategy. It's about three things.
It's about having the right vaccine technology, the right business capabilities, and about creating the right customer experience. I would say that our differentiation strategy is equal parts of each of these three things. But I want to take a moment to comment on our customer experience focus because it gives you a little bit of a glimpse into our culture, which I believe underpins a lot of our success. As a flu-focused business, we ground our company's purpose in meeting our customers' needs, the healthcare providers. We essentially reverse-engineer from their vaccine and operational needs to determine where our focus and resources should be directed. Now, let me bring some of these capabilities to life with a few examples of what sets Seqirus apart from the competition. Let's start with what makes our technology and our portfolio so valuable from a clinical perspective.
Now, when you look at flu, there are many circulating strains each year as depicted on this graphic. The WHO then selects the strains that they believe will be the most prominent for the upcoming season. When it comes to standard egg-based vaccines, the problem is that egg adaptation happens in the manufacturing process. This occurs because you're growing a mammalian virus, one that can infect a human, in an avian egg. And this adaptation will lead to some drift from the selected strain that can cause a standard egg-based vaccine to be less effective. Now, to solve this problem in our senior population, we add MF59 adjuvant to our vaccine to make Fluad. This adjuvant is designed to provide a boost to their weakened immune system of that senior population a nd to provide a greater breadth of protection. Then, for those under 65, we have our cell-based vaccines.
That's Flucelvax, which avoids that egg adaptation I just mentioned by creating an exact match to that selected strain. And there's a growing compendium of real-world evidence that's showing that Flucelvax is providing better protection than standard egg-based vaccine, especially when there's significant egg adaptation. And then, when we look to the future, we're working on our aTIVc vaccine. That's our adjuvanted trivalent cell-based vaccine. That combines an optimized dose of our adjuvant with an optimized dose of our cell-based antigen to create what we believe has the potential to become the new standard of care for the populations for which it's licensed. Now, let me take a moment to give you an update on where we are with aTIVc. The phase III immunogenicity study has been completed. And based upon those results, we have already filed for licensure in the U.K. and in the E.U.
with expected approvals at the end of FY 2026. And with recent FDA input, we're now in the process of developing the study protocols and plans for the launch in the U.S. and other markets. Now, when you pull together all of this, what you could say is that we are the only flu vaccine manufacturer who can offer a differentiated vaccine for all recommended populations: pediatrics, adults, and the senior population. Now, let me shift gears to another strategic capability that we developed to help shape the markets in which we operate. One of the things that I am most proud of is how we have led the way to elevate the value of real-world evidence in shaping vaccine policy and NITAG recommendations around the world. And by doing so, improving public health while creating new commercial opportunities for Seqirus.
In the past, RCTs, randomized clinical trials, were the only basis on which NITAG recommendations were made. This meant that an RCT done 10 or 15 years ago on a vaccine formulation that is no longer in use for strains that are likely no longer circulating was the definitive statement on a vaccine's effectiveness. Now, while RCTs are important, it stands to reason that if we could design and implement rigorous real-world evidence studies that are faster and cheaper to execute and could be run over multiple seasons to track the effectiveness against varying strains, that we'd be able to provide healthcare providers with more comprehensive information to inform their clinical decision-making. And that's exactly what we have and will continue to do as part of our differentiation strategy. Now, applying this approach to Fluad, we've helped drive preferential recommendations in 19 countries for enhanced vaccines like Fluad.
That's raising the standard of care for those target populations. We've also taken the same real-world evidence strategy for Flucelvax to demonstrate its benefits versus standard egg-based vaccines in both the pediatric and the adult population. The bottom line is that we're using our flu expertise, w e're challenging the status quo in how recommendations are made, a nd we're thinking differently about what our healthcare providers need to make better and more informed clinical decisions. We're shaping the markets in ways that improve public health while creating growth opportunities for our products. We've taken this same market-shaping approach to how we run our pandemic flu business. We've chosen to leverage our flu expertise to help governments improve their pandemic preparedness with a unique business model that has three distinct revenue streams.
The first is our advance purchase agreement, what we call APAs, that creates annual recurring revenue streams from reservation fees paid that we receive in exchange for a portion of our pandemic vaccine capacity. The second is, i f a pandemic is declared, we would then sell those governments the volumes agreed to in those APAs, the first wave of which would generate $3.5 billion in revenue. The third part of the business model is that we've partnered with those same governments around the world to prepare pre-pandemic vaccine stockpiles for viruses of concern that are circulating within animals. While this revenue stream is more sporadic, when it does happen, we're ready to respond. For example, during last year's H5 outbreak, Seqirus captured nearly 90% of all of the outbreak demand around the world.
One of the strategic capabilities that enables our pandemic business is our operational excellence within manufacturing, which is the last topic I'd like to share with you before I shift gears to where we see growth in the future. As I've mentioned earlier, the challenges of annual strain changes coupled with the unique supply chain needed and the condensed manufacturing cycle time creates meaningful opportunities for differentiation. Our investments to date have strengthened our global footprint, enhanced our capabilities, and created the agility needed to serve our northern and southern hemisphere customers while creating the warm base needed to execute our pandemic strategy. When you combine that industrial capability with our customer-focused culture, you create the reliability our customers need to achieve their immunization goals while also creating the agility needed to take advantage of opportunities when they present themselves, like we did with the H5 outbreak.
This leaves one piece of information I'd like to share with you. And that's where we see our future growth coming from. Now, we see different growth drivers across the short and medium term. So let me start in the U.S., where I'd like to highlight two near-term opportunities. The first is in the pediatric segment of the market, where there is currently utilization of about 30 million-32 million doses. That represents about $500 million worth of market value. With the benefits I've shared earlier about Flucelvax, we have the only differentiated vaccine that covers the full age range for the pediatric population, which creates an opportunity to take a leading market share position over the coming years. We have a very similar opportunity within the health system space.
That's the hospital system space, where we can now offer the only fully differentiated portfolio that covers all age ranges that are cared for in this setting. Then, outside of the U.S., geographic expansion remains our key strategy. With recently implemented preferential recommendations for the senior population, we have significant growth opportunities in Germany, France, the Nordics, among others. And as we continue to have success shaping markets and driving preferential recommendations in senior markets, we will continue to expand our international targets. To support all of these opportunities, we have had a targeted expansion of our sales force to extend our reach and frequency with the top immunizers. What you also need to account for is that most of the market value you see on this slide will grow as we convert it from the standard egg-based vaccine that it is currently to the higher-value differentiated product.
In many cases, there's a potential to double the current value of these targets. Now, in the medium term, we will continue to penetrate the markets we serve. But we also see the U.S. market recovery as an accelerant to our strategy, bringing new volume to existing customers and creating the opportunity for price appreciation across the broader market. Also, starting in the medium term and continuing into the longer-term horizon, we see the launch of aTIVc as establishing a new standard of care for the patients for which it's designed. The value of aTIVc will be created from three different things. It will allow us to grow market share while we displace competitive share. It will allow for a premium price based upon its expected health economic benefits, and it will strengthen our portfolio offer for those customers who want different options for different patients.
Now, I know I've shared a lot of information with you, but hopefully it was all in the service of demonstrating those three things that I started with, and that is that the uniquely complex influenza market creates opportunities for strategic and lasting differentiation, that the strategy, capabilities, and performance of Seqirus sets us apart from the competition, and that while the current U.S. market conditions are challenging, there's reason to believe in its recovery and that that recovery will act as a growth accelerant for our strategy, so with that, thank you for your attention, and I'd like to invite Paul and Ken to the stage for the Q&A portion of this agenda.