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Flu vaccine reduces severe illness in kids, but coverage remains low
Laine Bergeson
Today at 8:54 a.m.
Influenza Vaccines
Influenza, General Two large-scale studies published this month in Pediatrics suggest that seasonal flu vaccination provides meaningful protection against outpatient visits and hospitalization in children. Despite the clear protective benefits of vaccination, however, flu vaccination rates remain low, and—argue Eric J. Chow, MD, MPH, of the Seattle and King County, Washington, public health department and coauthors in an accompanying commentary—public health messaging may be undermining uptake.
In a US-based analysis of nearly 20,000 children diagnosed as having an acute respiratory infection, researchers from the Centers for Disease Control and Prevention found that vaccination reduced the risk of flu-related hospitalization and outpatient visits by 34% during the 2021–22 season, 51% in 2022–23, and 60% in 2023–24. Overall vaccine effectiveness (VE) against infection across all observed seasons was 55%.
Protection varied by strain. Across all seasons, VE was highest against influenza B (69%) compared with 43% against influenza A/H3N2.
A separate study of pediatric patients in Europe found even higher protection among those seeking primary care for flu-related illness. Across the 2022–23 and 2023–24 seasons, VE against primary care–attended flu ranged from 68% to 71% overall, with particularly strong protection against influenza B (83% to 92%). The data found that the overall VE against any influenza was at least 65% across both seasons.
Taken together, the studies reinforce that flu vaccination provides consistent, moderate protection for children. “Across multiple seasons, influenza vaccination was found to offer notable protection against outpatient visits and hospitalizations in children,” notes the commentary.
Low vaccination rates despite clear benefits
Despite the evidence that the flu vaccine offers protection against medically attended illness, childhood vaccination rates remain low, the commentary authors said.
In the United States, only about half of children (49%) received the annual flu shot during the 2024–25 season, which represents a 4.2% drop from the year before and a 13.2% drop from before the pandemic.
That remains well below the Healthy People 2030 target of 70% coverage. In Europe, median vaccination coverage among children has increased modestly in recent years, with a 5% increase in 2021–22, a 10% increase in 2022–23, and a 7.2% increase in 2023–24. But, note the authors, there are significant disparities between countries.
“The gap between demonstrated vaccine benefits and actual uptake underscores the need to assess how we frame and deliver messages about influenza vaccine effectiveness,” Chow and colleagues said.
The gap between demonstrated vaccine benefits and actual uptake underscores the need to assess how we frame and deliver messages about influenza vaccine effectiveness.
Part of the problem with current health messaging, they write, is that it often fails to explain that vaccines work in different ways. For example, the measles, mumps, and rubella (MMR) vaccine is about 97% effective at preventing measles infection. People who are fully vaccinated are not only far less likely to develop severe measles but are also unlikely to become infected at all.
In contrast, flu vaccines are not designed to prevent every infection. Their primary benefit is reducing the risk of outpatient visits, hospitalization, and death. When those distinctions aren’t clearly communicated, it can lead to misplaced expectations.
Families may mistakenly believe that flu vaccines should prevent infection entirely, so when a vaccinated child gets sick, it can feel like a breach of trust, notes the commentary. This may be especially true in the context of widespread health misinformation on social media and post-pandemic messaging fatigue.
Clearer messaging key amid vaccine skepticism
With vaccine skepticism on the rise, public health and healthcare professionals need to respond to flu vaccine misperceptions, note the commentary authors, who advocates for engaging people with empathy and not dismissing their frustrations when their vaccinated child still catches the flu.
The commentary also suggests that public health messages move away from default assurances and be more forthright. “This means being upfront with patients and families that flu shots may not prevent infection, while emphasizing its benefits: decreasing severity of symptoms, shortening the duration of illness, reducing the chance of hospitalization, and minimizing household transmission.”
Together, the studies add to a substantial body of evidence showing that influenza vaccination helps prevent severe outcomes in children. But as the commentary authors note, “the real-world value of these findings depends on how they are communicated.”
Flu vaccine reduces severe illness in kids, but coverage remains low
Laine Bergeson
Today at 8:54 a.m.
Influenza Vaccines
Influenza, General Two large-scale studies published this month in Pediatrics suggest that seasonal flu vaccination provides meaningful protection against outpatient visits and hospitalization in children. Despite the clear protective benefits of vaccination, however, flu vaccination rates remain low, and—argue Eric J. Chow, MD, MPH, of the Seattle and King County, Washington, public health department and coauthors in an accompanying commentary—public health messaging may be undermining uptake.
In a US-based analysis of nearly 20,000 children diagnosed as having an acute respiratory infection, researchers from the Centers for Disease Control and Prevention found that vaccination reduced the risk of flu-related hospitalization and outpatient visits by 34% during the 2021–22 season, 51% in 2022–23, and 60% in 2023–24. Overall vaccine effectiveness (VE) against infection across all observed seasons was 55%.
Protection varied by strain. Across all seasons, VE was highest against influenza B (69%) compared with 43% against influenza A/H3N2.
A separate study of pediatric patients in Europe found even higher protection among those seeking primary care for flu-related illness. Across the 2022–23 and 2023–24 seasons, VE against primary care–attended flu ranged from 68% to 71% overall, with particularly strong protection against influenza B (83% to 92%). The data found that the overall VE against any influenza was at least 65% across both seasons.
Taken together, the studies reinforce that flu vaccination provides consistent, moderate protection for children. “Across multiple seasons, influenza vaccination was found to offer notable protection against outpatient visits and hospitalizations in children,” notes the commentary.
Low vaccination rates despite clear benefits
Despite the evidence that the flu vaccine offers protection against medically attended illness, childhood vaccination rates remain low, the commentary authors said.
In the United States, only about half of children (49%) received the annual flu shot during the 2024–25 season, which represents a 4.2% drop from the year before and a 13.2% drop from before the pandemic.
That remains well below the Healthy People 2030 target of 70% coverage. In Europe, median vaccination coverage among children has increased modestly in recent years, with a 5% increase in 2021–22, a 10% increase in 2022–23, and a 7.2% increase in 2023–24. But, note the authors, there are significant disparities between countries.
“The gap between demonstrated vaccine benefits and actual uptake underscores the need to assess how we frame and deliver messages about influenza vaccine effectiveness,” Chow and colleagues said.
The gap between demonstrated vaccine benefits and actual uptake underscores the need to assess how we frame and deliver messages about influenza vaccine effectiveness.
Part of the problem with current health messaging, they write, is that it often fails to explain that vaccines work in different ways. For example, the measles, mumps, and rubella (MMR) vaccine is about 97% effective at preventing measles infection. People who are fully vaccinated are not only far less likely to develop severe measles but are also unlikely to become infected at all.
In contrast, flu vaccines are not designed to prevent every infection. Their primary benefit is reducing the risk of outpatient visits, hospitalization, and death. When those distinctions aren’t clearly communicated, it can lead to misplaced expectations.
Families may mistakenly believe that flu vaccines should prevent infection entirely, so when a vaccinated child gets sick, it can feel like a breach of trust, notes the commentary. This may be especially true in the context of widespread health misinformation on social media and post-pandemic messaging fatigue.
Clearer messaging key amid vaccine skepticism
With vaccine skepticism on the rise, public health and healthcare professionals need to respond to flu vaccine misperceptions, note the commentary authors, who advocates for engaging people with empathy and not dismissing their frustrations when their vaccinated child still catches the flu.
The commentary also suggests that public health messages move away from default assurances and be more forthright. “This means being upfront with patients and families that flu shots may not prevent infection, while emphasizing its benefits: decreasing severity of symptoms, shortening the duration of illness, reducing the chance of hospitalization, and minimizing household transmission.”
Together, the studies add to a substantial body of evidence showing that influenza vaccination helps prevent severe outcomes in children. But as the commentary authors note, “the real-world value of these findings depends on how they are communicated.”