CDC Report Reveals Decline in Pediatric Vaccinations -- What Does This Mean for Flu?

Gregg Sylvester, MD, MPH


September 26, 2022

Over the course of the pandemic, flu case rates have been strikingly low, likely caused by people wearing masks and social distancing. However, as we remained indoors, an unforeseeable consequence occurred: childhood vaccination rates declined and routine visits to the pediatrician also fell in tandem.

According to the Centers for Disease Control and Prevention (CDC), vaccination rates for kindergartners dropped across the U.S. during the 2020/21 school year, with rates of routine vaccination for all required vaccines falling roughly one percent nationally since 2019/20. While one percent may not seem like much, this decline equates to approximately 35,000 kindergarten children. Notably, flu vaccinations saw an even steeper decline of five percent in 2020/21, with a continued decrease of two percent into the 2021/22 influenza season.

Since many children participated in remote learning beginning in March 2020, getting vaccinated against viruses that often involve human-to-human contact may not have seemed like a priority at the time. While we frequently think of children as being healthy and quickly able to recover, diseases such as influenza, measles, and whooping cough can range from mild to life-threatening for young children who are not vaccinated.

As COVID-19 mitigation measures are being lifted, in-person activities return in full swing, children are now back in school, and those who are not vaccinated put others at risk of infection, the likelihood of an influenza resurgence increases. A spike in flu has already been seen across the Southern Hemisphere and serves as a potential indicator of what may occur in the upcoming Northern Hemisphere 2022/23 flu season.

Vaccination is a vital tool to help keep children healthy, minimize the risk of vaccine-preventable diseases, and help their immune systems identify and learn to fight viruses and bacteria. In addition, vaccination against influenza is designed to reduce the spread of infection and can help lessen the serious effects of infection. In schools, an environment where the transmission of diseases such as influenza is often higher and vulnerable populations like children are involved, it is imperative to consider receiving routine seasonal vaccination for influenza.

As a pediatrician and infectious disease specialist, I have seen the varying impact flu has had on my patients as influenza can affect people differently, especially those who have a higher risk of flu complications, including older adults and young children. Classic flu symptoms are often mild and include a fever, sore throat, cough, and all-over body aches. In more severe cases, influenza can lead to hospitalization or potentially be life-threatening. Even when a child’s illness is mild, influenza can have a big impact on children with days of school missed, which also disrupts the routine of a child’s parents or guardians.

In order to prevent both mild and severe cases of influenza in children, the CDC recommends that all eligible individuals aged six months and older get an annual influenza vaccine to help protect themselves and their loved ones from potentially serious influenza complications. In fact, the CDC found that flu vaccination reduced the risk of severe influenza by roughly 50 to 75 percent and life-threatening influenza in children (<18 years of age) by over 75 percent.

There are currently several seasonal influenza vaccines available that offer protection for people of all ages who are eligible to be vaccinated in the U.S. For children (<18 years of age), there are two types of influenza vaccines available in the U.S. One option is the standard-dose quadrivalent influenza vaccine, which may provide protection against all four influenza virus strains recommended annually by the World Health Organization (WHO). Another option is the cell-based quadrivalent influenza vaccine, which also protects against the four influenza virus strains and is designed to produce an exact match to WHO-selected influenza virus strains. Notably, in younger children (6 months through 8 years of age who have not previously been vaccinated against the flu), two influenza vaccine doses are recommended for the best protection.

Physicians can help improve influenza vaccination rates for young children by engaging with parents and guardians about their child’s health and candidly discussing their vaccination options as well as by increasing vaccine accessibility. Examples of ways to enhance patient access to vaccines include partnering with schools and daycare centers to provide alternative vaccination environments, expanding office hours, and offering information about ways to receive vaccinations at free or minimal costs.

As the 2022/23 school year begins and flu season approaches, now is the time to engage with families on the importance of routine vaccination and its benefits, as well as to ensure that “vaccination” is crossed off back-to-school checklists.

Disclaimer: CSL Seqirus does not provide medical advice. This information is for educational and information purposes only. CSL Seqirus is not responsible for the selection of any treatment by a healthcare professional to be used on a particular patient. Those who receive a vaccine may have different results, which may vary depending on several factors.

Dr. Sylvester is an employee of CSL Seqirus.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.