Schmidtt & Nordyke (1995) state that the flu reached Hawaii through naval and military bases in June-July 1918. "In the worst flu year for the entire nation, 1918, civilian mortality from flu and pneumonia reached 562 per 100,000, compared with only 167 in the last full year before the pandemic. The peak rate per 100,000 for Hawai'i was 571 in 1920, as against 189 in 1917" (110). Some facilities (schools, theaters) closed temporarily, but not to the extent that they did on the mainland. "In Hawai'i, more than 2,338 persons died from influenza, bronchopneumonia, or lobar or unspecified pneumonia between July 1, 1918 and June 30, 1920" (115). Influenza Deaths in Hawai'i, 1918—1920

This history of influenza overview from the U.S. Dept. of Health and Human Services does not give a specific figure for the number of casualties, but states that "Hawaii does not appear to have suffered tremendously from the pandemic". Collection of morbidity and mortality data was hampered by the fact that Hawai'i wasn't a state, and was not required to report to the Public Health Service.

A 1919 report by U.S. Surgeon General W.H. Frost describes house-to-house canvassing conducted by the Public Health Service to assess the influenza epidemic, which was conducted in New York City, Cleveland, and San Francisco. Census records for influenza and pneumonia related deaths were also used to measure the burden of disease.

Shanks & Brundage (2012) discuss the relatively low mortality rates among several island populations, including Hawai'i and Puerto Rico.