Mortality monitoring is an important tool for the surveillance of pneumonia and influenza which can aid in the rapid detection and estimates of excess deaths and inform and evaluate the effect of vaccination and control programs. Traditionally, influenza mortality surveillance often uses the category of "pneumonia and influenza" (P-I) on death certificates as an indicator of the severity of an influenza season or to identify trends within a season; however, only a small proportion of these deaths are influenza related. It has been reported that only 8. [5] [6] [7] [8] [9] .8% of all pneumonia and influenza deaths are influenza related [14, 15] . The non-influenza-related pneumonia deaths tend to be stable from year to year and fluctuations in this category are largely driven by the prevalence and severity of seasonal influenza. As a result, the P-I category is an important sentinel indicator.