The United States is experiencing its deadliest flu season for children since the 2009 H1N1 swine flu pandemic, with 216 pediatric deaths reported to the Centers for Disease Control and Prevention (CDC) so far. This figure already exceeds last year's total of 207 deaths, and health officials expect the final count to rise further as data continues to be compiled.
"This number that we have now is almost certainly an undercount, and one that — when the season is declared over, and they compile all the data — it's almost certain to go up," said Dr. Sean O'Leary of the American Academy of Pediatrics.
Declining Vaccination Rates Raise Concerns
A significant drop in childhood flu vaccination rates appears to be a key factor in this season's severe toll. Only 49% of children received their flu shot this season, down from 64% five years ago. The decline has been particularly steep in recent months, with CDC data showing just 37% of children had been vaccinated by November 30, 2024 – a drop from 43% at the same time last year.
For the entirety of the 2023-2024 flu season, only 55% of children received the flu vaccine, marking the lowest rate in 12 years. Alicia Budd, head of the CDC's domestic influenza surveillance team, noted that while vaccination rates were slowly increasing before the pandemic, they have failed to rebound since.
Dr. Kristina Bryant, a pediatric infectious disease specialist at Norton Children's in Louisville, Kentucky, expressed concern: "I always have a little bit of dread when flu season is around the corner. Children experience illness and suffering during flu season, and much of that can be prevented through vaccination."
Vaccine Effectiveness and Disease Burden
This season's flu vaccine targets the two predominant circulating strains: H1N1 and H3N2. Early data indicates the vaccine has been effective at preventing serious illness, despite a preliminary CDC report suggesting potentially lower effectiveness (39%) at preventing hospitalizations in children under 5 compared to last year's estimate of up to 61%.
"Even if you're exposed and test positive for the flu, the vaccine gives the best chance of having a much easier course of illness than if you hadn't been vaccinated at all," emphasized Dr. Michelle Taylor, a pediatrician and health officer in Memphis.
The overall disease burden has been substantial across all age groups. The CDC estimates at least 47 million Americans have contracted influenza this season, resulting in approximately 610,000 hospitalizations and 26,000 deaths.
Hospitalization Patterns and Risk Factors
Analysis of hospitalization data reveals interesting patterns. Among the 5,200 adults hospitalized with flu this season, 95% had an underlying health condition. In contrast, only about half of the 2,000 hospitalized children had such conditions, like asthma or obesity, suggesting that previously healthy children remain vulnerable to severe influenza.
The CDC continues to recommend annual flu vaccination for everyone six months and older. For most individuals, a single shot provides adequate protection, though children receiving their first-ever flu vaccine require two doses spaced four weeks apart.
Barriers to Vaccination
Experts attribute the vaccination decline to multiple factors. Vaccine misinformation has increased hesitancy among some families. Access issues also play a role – many pediatric offices face staffing shortages and no longer offer evening vaccine clinics, while some pharmacies don't provide vaccinations for children.
"More than 80% of the reported influenza-associated pediatric deaths last season occurred in children who were eligible for a flu vaccine but weren't fully vaccinated," Budd noted, highlighting the critical importance of immunization.
Current Outlook
There is some encouraging news: flu activity has been declining since February, with all 50 states now reporting low or minimal flu levels. However, health officials stress that the season isn't over yet.
"My hope is that this season will be a bit of a wake-up call for folks that we actually do need to vaccinate our kids against influenza," Dr. O'Leary said, emphasizing that while flu shots don't always prevent symptoms, they are highly effective at preventing hospitalizations and deaths.
As the current flu season winds down, public health officials are already planning vaccination strategies for the coming year, with a renewed focus on improving childhood immunization rates to prevent another season of high mortality.
