The United States is currently experiencing one of the most severe flu seasons in recent decades, with rising cases and hospitalizations driven by a mutated influenza A variant known as H3N2 “subclade K.” Public health officials are warning that flu activity could persist for weeks, emphasizing the importance of vaccination. However, parents may find it more challenging to secure flu shots for their children due to recent changes in recommendations.
On January 5, the Centers for Disease Control and Prevention (CDC) revised its long-standing universal flu vaccine recommendation for children aged 6 months and older. Instead of advising all children to receive the shot, the CDC now suggests that the vaccine should only be administered after a discussion with a healthcare provider. This shift has sparked concern among medical experts, who argue that the new guidance could lead to confusion and fewer vaccinations.
The current flu season has been particularly harsh on children. At least 17 pediatric deaths have been reported so far, and the rate of hospitalizations among children is the second-highest observed in 15 years, according to NBC News. Flu metrics have already surpassed those of the previous season, which was one of the deadliest for children in over two decades. The 2024-2025 flu season resulted in 280 flu-related pediatric deaths, the highest number since the CDC began tracking such data in 2004, excluding the 2009-2010 swine flu pandemic. Nearly all of these children were unvaccinated.
Dr. Yvonne Maldonado, a pediatric infectious disease epidemiologist at Stanford University, described the situation as “more than unfortunate; it’s tragic.” She emphasized that flu shots are among the most effective interventions in reducing child deaths in the U.S. over the past century. Leading medical organizations, including the American Academy of Pediatrics and the Infectious Disease Society of America, have criticized the CDC’s updated guidance, arguing that there is ample scientific evidence supporting the effectiveness of the flu vaccine in children.
Despite the CDC’s change, the agency’s website still states that “the flu vaccine can prevent severe, life-threatening complications in children.” Dr. Pedro Piedra, a professor of molecular virology and pediatrics at Baylor College of Medicine, pointed out that several studies on the CDC site demonstrate the vaccine’s effectiveness in reducing severe illness, hospitalization, and even death in children.
Flu Vaccine Effectiveness in Children
The flu shot works by introducing small amounts of killed or weakened virus to the immune system, prompting the body to produce antibodies that can fight off the virus. While the vaccine does not always prevent infection, it significantly reduces the severity of symptoms. “If you’re vaccinated, you’re less likely to end up in the hospital, on a ventilator, or dying from the flu,” says Maldonado.
Flu shot effectiveness varies from year to year, typically ranging between 40-60%. However, research suggests it is even more effective among children. A 2022 study cited on the CDC website found that flu vaccination reduced the risk of severe illness in children by 75%. Another study from 2020 showed that the vaccine reduced flu-related hospitalization by 41% and emergency room visits by 50% during the 2017-2018 season. In 2017, a groundbreaking study demonstrated that flu vaccination reduced a child’s risk of dying from the flu by up to 65% for healthy children.
“If you look back every year at who’s been hospitalized and who’s died from flu, the overwhelming majority are unvaccinated,” Maldonado explains. Last season, 89% of children who died from the flu were not vaccinated, according to CDC data. This season, the U.K. Health Security Agency reports that the 2025-2026 flu vaccine is 70-75% effective at reducing hospitalizations among children, even if it is not a perfect match for the circulating strains.
The Flu Can Be Deadly for Any Child
About half of the 280 children who died from the flu last season had underlying medical conditions, while the rest were previously healthy. “Children have the highest infection rates of all groups because they have not seen the virus as often as adults,” says Piedra. In any given flu season, multiple strains circulate, and many children lack immunity to these strains.
Children under 2 and those with underlying conditions are at the highest risk, but most hospitalized children are healthy, Maldonado notes. Each year, an average of 100-200 children die from the flu in the U.S., often due to severe complications like pneumonia, encephalitis, or myocarditis. “Over 50% of the children that die don’t have any (underlying condition), but if you look at vaccination status, the vast majority have not been vaccinated,” Piedra adds.
Flu Complications Can Cause Permanent Damage
Even if children recover from the flu, complications can cause lasting damage. If the flu affects the brain or central nervous system, it can lead to seizures, learning disorders, or motor function difficulties. Recently, there has been a rise in a rare neurological complication called influenza-associated encephalopathy, where children can suddenly fall into a coma. “It was really frightening,” Maldonado explains. The most severe form, necrotizing encephalopathy, can cause permanent brain damage and disability.
“I’ve seen a kid who was mute from bad (brain swelling). … The flu can do so many things, it’s unbelievable,” says Dr. Jason Newland, chief of infectious disease at Nationwide Children’s Hospital. Vaccination remains the best way to protect against severe flu and its complications.
Severe Flu Symptoms in Children
The flu can progress rapidly in children. Although most will recover on their own, parents must monitor for severe symptoms. “About 25% of children die before they see a physician, and 25% die in the emergency room,” says Piedra. Flu often begins with a sudden fever, and children can go from being healthy in the morning to having a high fever by the afternoon. Common symptoms include fatigue, muscle aches, headache, sore throat, and coughing. Flu can also cause shortness of breath and gastrointestinal issues like vomiting and diarrhea, leading to dehydration.
“Kids may become quiet or not recognize things well,” says Piedra. Little kids can become fussy and irritable. Flu can also trigger myositis, a type of muscle inflammation, especially in the calf muscles. “If a child is having trouble walking or tiptoe walking, that’s an indication to get checked out,” says Dr. Daniel Park, medical director of UNC Children’s emergency department. Flu antivirals, such as oseltamivir, can help reduce symptoms, but they are most effective when taken early.
If a child exhibits severe or lingering symptoms, a high fever (over 104°F), trouble breathing, dehydration, extreme lethargy, or chest pain, parents should seek medical attention immediately. “Parents know their child. When something is out of the norm, take your child to see a physician,” says Piedra.
It’s Not Too Late to Get the Flu Shot
The flu vaccine is still available for all children 6 months and older after a conversation with a healthcare provider. It comes in a shot or nasal spray, which can be administered by a parent at home, says Piedra. He continues to recommend that all children get vaccinated against the flu. Talk to your doctor or pharmacist if you have questions. Despite the CDC’s guidance changes, the vaccine is still covered by insurance.
“Getting a yearly flu vaccination is the best way to reduce the risk from flu and its potentially serious complications,” the CDC states on its website for the 2025-2026 season. The flu shot protects against multiple strains, including flu B, which often surges later in the season.
As flu season continues, Maldonado offers this advice to concerned parents: “Trust your pediatrician.””Children should not be dying from a disease that’s preventable,” she adds.