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Estimated US flu vaccine efficacy against death in kids 80% over 8 seasons
Mary Van Beusekom, MS
Today at 3:22 p.m.
Influenza Vaccines
During eight respiratory illness seasons, estimated influenza vaccine effectiveness (VE) against death in US children was 80% overall, 77% in those who had underlying medical conditions, and 87% among those without such conditions, Centers for Disease Control and Prevention (CDC) researchers report today in Pediatrics.
The team used data from the US Influenza Associated Pediatric Mortality Surveillance System and survey data to estimate VE against death and assess vaccination status in children aged 6 months to 17 years who died of their infections from August 2016 through July 2025. The study excluded the 2020-21 flu season.
“Seasonal influenza vaccination has been shown to reduce the risk of influenza and severe complications among children aged 6 months and older,” the study authors noted. “Since 2010, reported numbers of influenza-associated pediatric deaths among children younger than 18 years have ranged from 37 during the 2011 to 2012 season to 289 during the 2024 to 2025 season.”
Over half of flu deaths were in otherwise healthy children
In total, 1,234 children aged 6 months to 17 years died of flu. Overall, 48% of pediatric deaths occurred in children with one or more underlying medical conditions and 52% in those without such conditions.
Of deaths in children with at least one high-risk condition, the greatest proportion of flu vaccination was in those with non-asthma lung disorders (35%), followed by immune-weakening conditions (33%) and genetic and mitochondrial disorders (29%) and was lowest among those with obesity (18%), diabetes (11%), and hemoglobinopathies such as sickle cell disease (8%).
Findings of this analysis highlight the importance of seasonal influenza vaccination to prevent severe illness and complications of influenza in children and adolescents.
Among 1,086 deaths with flu vaccination data, only 23% of 530 children with chronic conditions and 13% of 556 children without these conditions were fully vaccinated against flu. By season, the proportion of flu deaths in children vaccinated in the current year ranged from 26% in 2018-19 to 9% in 2024-25.
Vaccination rates ranged from 42% to 50% among children with high-risk medical conditions and 39% to 48% in their otherwise-healthy peers.
VE against death was 80% overall, 77% among children with underlying medical conditions, and 87% in children without these conditions. VE against influenza A death in children with high-risk conditions was 68% and 77% against death related to influenza B, while VE in otherwise-healthy children was 87% against both influenza A and B.
Among children with high-risk underlying conditions, VE estimates were higher for those aged 6 months to 4 years (83%) than for those aged 13 to 17 (66%). In children without such conditions, VE was also higher for those aged 6 months to 4 years (89%) than for those 13 to 17 (80%).
Sensitivity analyses accounting for potential overestimation of flu vaccine coverage in US survey data confirmed the association between vaccination and protection.
While neurologic, cardiac, and pulmonary conditions and genetic disorders are tied to a higher risk of flu death among children, the researchers noted that those with no underlying conditions make up roughly half of flu-related pediatric deaths.
“Together with recent reports on the large number of influenza-associated pediatric deaths during the 2024 through 2025 influenza season and low influenza vaccination among children with influenza-associated necrotizing encephalopathy [severe brain swelling], findings of this analysis highlight the importance of seasonal influenza vaccination to prevent severe illness and complications of influenza in children and adolescents,” they concluded.
Emphasizing role of vaccines in averting death
In a related commentary, Catherine Hahn, MD, Anne Sardi, MD, and Adam Ratner, MD, all of the New York University Grossman School of Medicine, said the study offers data for clinicians to share with families when discussing the flu vaccine.
“As pediatricians, we need to shift parental expectations of the influenza vaccine from preventing all cases of influenza infection to protecting against severe disease and the tragedy of influenza-associated child mortality,” they wrote.
“The maintenance of public health infrastructure, including active surveillance and vaccine registries, is essential for accurate analysis of vaccine effectiveness and determining where vaccine advocacy efforts are needed,” they concluded.
Estimated US flu vaccine efficacy against death in kids 80% over 8 seasons
Mary Van Beusekom, MS
Today at 3:22 p.m.
Influenza Vaccines
During eight respiratory illness seasons, estimated influenza vaccine effectiveness (VE) against death in US children was 80% overall, 77% in those who had underlying medical conditions, and 87% among those without such conditions, Centers for Disease Control and Prevention (CDC) researchers report today in Pediatrics.
The team used data from the US Influenza Associated Pediatric Mortality Surveillance System and survey data to estimate VE against death and assess vaccination status in children aged 6 months to 17 years who died of their infections from August 2016 through July 2025. The study excluded the 2020-21 flu season.
“Seasonal influenza vaccination has been shown to reduce the risk of influenza and severe complications among children aged 6 months and older,” the study authors noted. “Since 2010, reported numbers of influenza-associated pediatric deaths among children younger than 18 years have ranged from 37 during the 2011 to 2012 season to 289 during the 2024 to 2025 season.”
Over half of flu deaths were in otherwise healthy children
In total, 1,234 children aged 6 months to 17 years died of flu. Overall, 48% of pediatric deaths occurred in children with one or more underlying medical conditions and 52% in those without such conditions.
Of deaths in children with at least one high-risk condition, the greatest proportion of flu vaccination was in those with non-asthma lung disorders (35%), followed by immune-weakening conditions (33%) and genetic and mitochondrial disorders (29%) and was lowest among those with obesity (18%), diabetes (11%), and hemoglobinopathies such as sickle cell disease (8%).
Findings of this analysis highlight the importance of seasonal influenza vaccination to prevent severe illness and complications of influenza in children and adolescents.
Among 1,086 deaths with flu vaccination data, only 23% of 530 children with chronic conditions and 13% of 556 children without these conditions were fully vaccinated against flu. By season, the proportion of flu deaths in children vaccinated in the current year ranged from 26% in 2018-19 to 9% in 2024-25.
Vaccination rates ranged from 42% to 50% among children with high-risk medical conditions and 39% to 48% in their otherwise-healthy peers.
VE against death was 80% overall, 77% among children with underlying medical conditions, and 87% in children without these conditions. VE against influenza A death in children with high-risk conditions was 68% and 77% against death related to influenza B, while VE in otherwise-healthy children was 87% against both influenza A and B.
Among children with high-risk underlying conditions, VE estimates were higher for those aged 6 months to 4 years (83%) than for those aged 13 to 17 (66%). In children without such conditions, VE was also higher for those aged 6 months to 4 years (89%) than for those 13 to 17 (80%).
Sensitivity analyses accounting for potential overestimation of flu vaccine coverage in US survey data confirmed the association between vaccination and protection.
While neurologic, cardiac, and pulmonary conditions and genetic disorders are tied to a higher risk of flu death among children, the researchers noted that those with no underlying conditions make up roughly half of flu-related pediatric deaths.
“Together with recent reports on the large number of influenza-associated pediatric deaths during the 2024 through 2025 influenza season and low influenza vaccination among children with influenza-associated necrotizing encephalopathy [severe brain swelling], findings of this analysis highlight the importance of seasonal influenza vaccination to prevent severe illness and complications of influenza in children and adolescents,” they concluded.
Emphasizing role of vaccines in averting death
In a related commentary, Catherine Hahn, MD, Anne Sardi, MD, and Adam Ratner, MD, all of the New York University Grossman School of Medicine, said the study offers data for clinicians to share with families when discussing the flu vaccine.
“As pediatricians, we need to shift parental expectations of the influenza vaccine from preventing all cases of influenza infection to protecting against severe disease and the tragedy of influenza-associated child mortality,” they wrote.
“The maintenance of public health infrastructure, including active surveillance and vaccine registries, is essential for accurate analysis of vaccine effectiveness and determining where vaccine advocacy efforts are needed,” they concluded.