evidence: Since 1918, there have been several other influenza pandemics, although none as deadly. A flu pandemic from 1957 to 1958 killed around 2 million people worldwide, including some 70,000 people in the United States, and a pandemic from 1968 to 1969 killed approximately 1 million people, including some 34,000 Americans. More than 12,000 Americans perished during the H1N1 (or "swine flu") pandemic that occurred from 2009 to 2010. The COVID-19 pandemic, which started in December 2019, spread around the world before an effective COVID-19 vaccine was made available in December 2020. By May of 2023, when the World Health Organization declared an end to the global coronavirus emergency, almost 7 million people had died of COVID-19.