TOPLINE

Children who died from influenza-associated illness were less likely to have received the current-season vaccination than age-matched peers in the same state. Influenza vaccine effectiveness was 80%, with fewer than 1 in 5 pediatric deaths occurring in fully vaccinated children.

METHODOLOGY

• Researchers analyzed current-season influenza vaccination status among 1234 reported influenza-associated pediatric deaths in the US and compared it with survey estimates of vaccination coverage among pediatric age groups across eight influenza seasons (2016-2017 through 2019-2020 and 2021-2022 through 2024-2025).
• Deaths were reported to the US Influenza-Associated Pediatric Mortality Surveillance System and included children aged 6 months to 17 years with laboratory-confirmed influenza virus infection from 51 jurisdictions in the US.
• Children were classified as fully vaccinated if they received one or two doses of the current-season influenza vaccine, as recommended, at least 14 days before illness onset; children aged 6 months to 8 years who were previously unvaccinated and received one dose at least 14 days before were considered partially vaccinated.
• Data on vaccination status and underlying medical conditions were collected.
• Vaccine effectiveness was calculated as (1 - odds ratio) × 100, with odds ratios estimated using logistic regression comparing the odds of vaccination among children who died with vaccination coverage in comparison cohorts.

TAKEAWAY

• In 1086 influenza-associated deaths with vaccination information, 18% occurred in fully vaccinated children and 82% occurred in unvaccinated children; the overall vaccine effectiveness was 80%.
• Vaccine effectiveness against death was 77% in children with known high-risk medical conditions and 87% in those without such conditions.
• In children with high-risk medical conditions, vaccine effectiveness was higher for those aged 6 months to 4 years at 83% than for those aged 13-17 years at 66%. Vaccine effectiveness against influenza A- and influenza B-associated deaths was 68% and 77%, respectively.
• Influenza vaccine effectiveness against pediatric deaths each season in children with high-risk medical conditions ranged from 66% in 2019-2020 to 84% in 2024-2025; vaccine effectiveness each season in children without known high-risk conditions ranged from 77% in 2022-2023 to 95% in 2024-2025.

IN PRACTICE

“[F]indings of this analysis highlight the importance of seasonal influenza vaccination to prevent severe illness and complications of influenza in children and adolescents,” the researchers wrote.

“Regular seasonal vaccination remains safe and the most effective way to prevent serious illness and death from influenza in children. Increased vaccine uptake is necessary to decrease pediatric influenza mortality,” experts wrote in an accompanying commentary.

SOURCE

This study was led by Jerome S. Leonard, MD, MPHTM, of the Influenza Division at CDC in Atlanta. It was published online on July 6, 2026, in Pediatrics. The commentary was written by Catherine Hahn, MD, Anne Sardi, MD, and Adam J. Ratner, MD, MPH, of New York University Grossman School of Medicine, New York City.

LIMITATIONS

Deaths due to influenza without laboratory confirmation were not reported and may not represent all influenza-related deaths. Vaccination may not have been recorded in immunization records available to health department personnel, which may result in incorrect classification of current season influenza vaccination status of vaccinated children, thereby overestimating vaccine effectiveness. Underlying medical conditions may not have been recorded for some children and adolescents.

DISCLOSURES

The authors disclosed no relevant funding sources for this study. The authors declared that the results and conclusions presented in the report were those of the authors and did not necessarily represent the views of the CDC.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.