Pediatric Influenza
The 2024-25 influenza season in the U.S. saw the highest number of pediatric deaths reported in a non-pandemic season since flu-associated child deaths became nationally notifiable in 2004.
As of September 13, 2025, there were 280 pediatric deaths attributed to influenza among children <18 years old.
This corresponds to a rate of about 3.8 deaths per 1 million children.
Demographics & Characteristics
Age distribution:
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Median age at death was ~7 years.
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Highest mortality rate among infants <6 months (≈11.1 per million).
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Significant proportion of deaths among children <9 years.
Underlying medical conditions:
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About 56% of children who died had at least one pre-existing chronic condition.
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Common comorbid conditions included neurologic conditions.
Virus types:
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Influenza A was involved in most (≈86%) of pediatric deaths.
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Among those with subtype information, A(H1N1)pdm09 and A(H3N2) were both significant.
Vaccination & Treatment
Vaccination status:
Among children eligible for influenza vaccination with known vaccination data (~208 children), ~89% were not fully vaccinated.
This suggests under-vaccination is a major contributor to mortality.
Antiviral treatment:
Only 40% of children who died received influenza antiviral medications.
Earlier use of antivirals may help reduce severe outcomes, especially for high-risk children.
Temporal & Other Patterns
Deaths peaked in February 2025 (weeks ending February 8 and February 15).
Mortality was higher in some racial/ethnic groups: e.g. Black children had a higher death rate per million compared to White or Asian children.
Mortality was also higher in very young infants (<6 months), who are ineligible or only partially protected by vaccination in many cases.
Comparison to Previous Seasons / Severity
The number (280) exceeded the previous record for a non-pandemic season, which was 210 in the 2023-24 season.
The only season with more pediatric deaths was the 2009-10 H1N1 pandemic.
The 2024-25 flu season has been officially classified as high severity for all age groups.
Implications & Public Health Messages
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Large majority of deaths occurred in children who were not fully vaccinated. More aggressive efforts to improve vaccine coverage in children (including infants as eligible, parents, caregivers) are needed.
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Given that only 40% of fatal cases got antivirals, protocols should encourage rapid diagnosis and prompt treatment in high-risk children.
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Infants <6 months have high mortality, but can’t always be vaccinated; their protection relies heavily on “cocooning” (vaccinating people around them), maternal vaccination, hygiene.
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Children with chronic illnesses (especially neurologic conditions) need special attention.
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Disparities by race/ethnicity indicate that access to vaccination, healthcare, or early treatment may be uneven.
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Because flu may be perceived as “just a seasonal illness,” under-appreciation of its risk leads to under-vaccination. Stronger messaging needed.
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Ongoing reporting is essential; some of the data is preliminary. Having accurate, timely surveillance supports better resource allocation (vaccines, antivirals, hospital capacity).
Vaccination is crucial
Early antiviral treatment
Focus on vulnerable subpopulations
Equity & access issues
Public information & awareness
Surveillance & data completeness
