Flu shots prevent 80% of death in kids
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%).
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.
