Peak-season sales across cold and flu categories reached $6.36B in 2026, down 3.6% from the previous year. Traditional treatment categories saw the sharpest declines, including cough (-12.5%), sinus (-10.1%), sore throat (-8.1%) and cold/flu products (-6.1%).
At the same time, several prevention-oriented categories grew, including hand sanitizer, up 28.8%, nasal products, up 3.8%, aerosol disinfectants, up 1.8%, and facial tissue, up 1.1%.
According to Darren Seifer, VP of thought leadership, Home, Family & Baby at NIQ, the changing numbers suggest more than just a single soft season.
“The demographic shift is significant because it affects the underlying transmission dynamics that have historically fueled cold and flu demand,” he said.
Fewer children and smaller households
A major factor that is reshaping that dynamic is the evolving US household.
With fewer births, smaller average household sizes and delayed family formation, the number of homes with children is declining, which has historically been an important purchase driver of upper respiratory products.
NIQ data shows upper respiratory category penetration at 84.6% among households with children compared with 78.8% among households without children. The average household size also dropped from 2.6 occupants in 2010 to 2.5 in 2024.
“These trends collectively reduce the number of ‘transmission engines’ that historically drove category growth,” Seifer said.
The demographic shift could create a structural headwind for traditional upper respiratory products rather than representing a temporary change in seasonal demand.
Either way, Seifer said the opportunity is not disappearing.
The market has traditionally relied on the model where consumers wait until they become sick and then purchase a product to address symptoms. Seifer said today’s consumer isn’t waiting.
“Consumers are increasingly engaging with products focused on staying well rather than only helping them recover once they get sick,” he said.
From treating sickness to staying well
The ‘staying well’ approach is also reflected in growing supplement use across generations. Supplement penetration is on the rise among all age groups, with Gen Z showing the fastest growth. Among Gen Z consumers, penetration increased from 71.8% to 82.7% over the past two years, an 11-percentage-point gain.
“The clearest evidence is the rapid growth in supplement usage among younger consumers,” Seifer said.
“We also see broader evidence of a wellness-first mindset. NIQ’s health and wellness research shows that 70% of consumers consider themselves proactive in managing their health, and a majority say they prioritize aging well more than they did five years ago.”
Taken together, the data suggests a shift in how consumers think about health, Seifer said.
“Younger consumers are increasingly viewing health as an everyday lifestyle commitment rather than something that becomes important only when illness strikes.”
That behavior insight could be particularly useful for supplement brands to keep in mind as consumers build broader routines around wellness, nutrition and prevention.
Supplements enter the respiratory basket
Supplements are already participating in the broader cold and flu shopping occasion, according to NIQ data.
Upper respiratory purchases resulted in a 37% basket spend jump, with the average basket containing upper respiratory products valued at $66.96, compared to $48.81 when upper respiratory products were not included.
Supplements were the most common co-purchase identified in the NIQ data, appearing in 6.5% of upper respiratory trips. Vitamins appeared in 3.4% of trips.
Seifer said the purchasing patterns indicate consumers increasingly view respiratory health as part of a broader wellness mission as opposed to an isolated medicine purchase.
“It’s a strong indication that consumers don’t view upper respiratory products in isolation anymore,” he said.
“When shoppers are buying cold and flu-related products, they’re also purchasing supplements and vitamins at meaningful rates, suggesting they’re thinking about both prevention and recovery at the same time.”
That insight suggests dietary supplement marketers may want to consider broadening the opportunity around seasonal health rather than the traditional immune-support positioning.
Seifer said the NIQ data also shows an overlap across supplements, functional foods and beverages, immunity-support products and traditional respiratory categories.
“Consumers are building a broader toolbox for staying healthy, and supplements are an important part of that broader health and wellness landscape,” he said.
Prevention is the new black
The cold and flu market is being reshaped from both sides: demographic changes are reducing some of the traditional drivers of demand, while consumers’ growing focus on proactive health is creating new purchase occasions.
For supplement brands, that may mean an opportunity to participate in seasonal health preparation without framing products solely as solutions for seasonal ailments.
“Many consumers appear to be asking, ‘How do I stay healthy?’ rather than simply, ‘How do I treat symptoms?’” Seifer said.
That distinction could become increasingly important as brands compete for consumers who are preparing for seasonal health challenges rather than waiting for them to arrive.
“The brands best positioned for growth will likely be those that position themselves within a broader wellness and preparedness ecosystem instead of relying solely on symptom relief messaging,” Seifer said.
