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Jump to Key Points Every year, the weeks after the start of the school year see a marked increase in asthma attacks among children under 15. That is why it is important to get a flu shot — the best way to prevent severe cases of the flu — and to follow preventive measures.
Up 135% in Emergency Room Visits
“Every year, the weeks after school starts see a peak in asthma attacks among children under 15, with a sharp increase in emergency room visits and calls to SOS Médecins, a French physician-on-call service that provides urgent home visits and out-of-hours care,” noted the Gregory Pariente Foundation, named after a French teenager who died at age 14 from an acute asthma attack.
For example, in 2025, the national peak occurred in week 37 (September 8-14), the second week after school started, according to Santé publique France, France’s national public health agency, with a 135% increase (1968 more visits) in emergency room visits and a 111% increase in calls to SOS Médecins (307 procedures).
How can this phenomenon be explained? The start of the school year brings together several factors likely to trigger exacerbations: a return to group settings, the circulation of respiratory viruses — including the flu virus — a return to certain exposures in school environments such as formaldehyde and volatile organic compounds in some classrooms and allergens, and the need to resume background treatment properly.
- Post-school-start asthma flares in children <15 show marked seasonal peak.
- 2025 week 37: ER visits ↑135% (+1968); SOS Médecins calls ↑111% (+307).
- Triggers: group settings, respiratory viruses incl flu, classroom allergens/VOCs/formaldehyde.
- Resume controller therapy early; summer treatment pauses may increase exacerbation risk.
- Flu vaccine before mid-October + hygiene, ventilation, masking reduce fall/winter risk.
Planning Ahead
Given that “in children with asthma, the flu can cause a severe asthma exacerbation, pneumonia, or a serious respiratory infection that may lead to hospitalization,” it is essential to resume maintenance therapy early — which is often paused during the summer — and to schedule the flu vaccination appointment before the virus begins to circulate,” noted Françoise Pariente Ichou, scientific director of the Gregory Pariente Foundation.
It is important to note that asthma is the leading comorbidity among patients hospitalized for the flu, particularly among children, and that children infected with a respiratory virus are three times more likely to experience severe asthma exacerbations.
Furthermore, children with asthma who are hospitalized for the flu have a 40% higher risk for pneumonia and a mortality rate three times higher in cases of pneumonia (0.9% vs 0.3% among children without asthma).
The key, therefore, is to plan ahead. “Anticipation means better preparing children with asthma for the succession of respiratory viruses during the fall and winter seasons and reducing the risk of flu-related complications,” explained Ichou. And the flu vaccine — recommended by the French National Authority for Health for eligible children with asthma — remains the best way to prevent severe forms of the flu.
However, to be effective, it must be administered before the virus begins to circulate actively, generally starting in mid-October. The start of the school year is the ideal time to prepare for the flu vaccine, and doctors have a vital role to play.
“An explicit recommendation from a healthcare professional remains one of the main factors influencing parents’ acceptance of the flu vaccine,” said Ichou. Every interaction with a family is an opportunity to answer parents’ questions, explain the expected benefits of vaccination, and help organize the vaccination process when it is recommended.
Six Preventive Measures
While waiting to get vaccinated — and even afterward — preventive measures can be adopted as soon as school starts:
- Wash your hands regularly (after using the restroom, after blowing your nose, and before eating).
- Cough or sneeze into your elbow and use disposable tissues.
- Do not share water bottles, utensils, cigarettes, or items that go in the mouth.
- Ventilate classrooms for 10 minutes before students arrive and during each recess and break between classes.
- Wear a mask during periods of high viral circulation. Its use may be considered on a case-by-case basis, in consultation with the student’s primary care physician (as part of the Asthma Action Plan or an Individualized Education Plan).
- Avoid contact with clothing on coat racks, on the stairs, and on the playground.
This story was translated from Medscape’s French edition.
