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Tag: flu vaccine

  • First child death reported from flu this season in Virginia – WTOP News

    Flu season has taken a grim turn in Virginia, as the state’s health department has reported the first death of a child caused by complications associated with influenza.

    Flu season has taken a grim turn in Virginia, as the state’s health department has reported the first death of a child caused by complications associated with influenza.

    In order to protect the family’s privacy, the only information the Virginia Department of Health is releasing about the child is that they were age 4 or younger and that the death was reported in the eastern region of the state.

    “We at the Virginia Department of Health, are broken hearted and extend our sympathies to the family of this child during this difficult time,” State Health Commissioner Karen Shelton said in a news release. “Even though the flu is common, it can cause serious illness and even death. I urge everyone who is eligible to receive the flu vaccine to do so not only to protect themselves, but to protect those around them.”

    Lisa Sollot, respiratory disease program coordinator with the state health department, told WTOP it’s not too late to get the flu vaccine.

    “This year, we were afforded a few extra weeks because activity started so late that I think it may have given us a little extra time for those who are may be procrastinating getting the vaccine,” she said. “We know that activity could start increasing at any minute, and so we know that there’s a lot ahead of us in terms of activity.”

    “We do recommend the flu vaccine as the best way to protect yourself and others,” she added.

    Sollot said it’s also important to take precautions, such as staying home when sick, avoiding others when they’re sick, cleaning high-tough surfaces and washing your hands frequently.

    Since COVID-19 came into the picture, Sollot said flu season has become a bit more unpredictable and it’s important for people to remain vigilant.

    “Typically, activity starts in about October, maybe November. And this year, we really didn’t have activity start until about December. And then it climbed rapidly, almost reaching last year’s peak, before also declining quickly, which is strange activity that we haven’t seen in the past,” she said.

    “It has also made us think that this is not necessarily a true decline, and that it is possible that we could see activity surge again in the future, which is why these prevention tips are so important to help protect yourself and your family,” she added.

    According to the state health department, less than 30% of eligible Virginians reported receiving a flu vaccine this season. Those interested in getting a flu shot can locate providers on the department’s website.

    The state health department said the level of respiratory illnesses are considered “moderate” — where over 18.6% of emergency department visits can be attributed to the viral illnesses.

    Last season was the deadliest flu season on record for children in the U.S., according to health officials in Virginia.

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    Thomas Robertson

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  • Doctors still recommend flu shot despite sneaky new strain

    Over the holidays, U.S. flu cases skyrocketed. 

    Weekly hospitalizations from the virus went from under 7,000 at the start of December to over 33,000 by the last week of 2025, surpassing rates of the past few years. 

    The Centers for Disease Control and Prevention estimate that more than 11 million people have gotten the flu so far this season, resulting in over 5,000 deaths.

    Why is it so bad? Doctors said that the surge in flu cases is largely related to a new mutation of the influenza A virus called “subclade K” — a strain that is not well covered by this year’s flu vaccine. 

    Each year, scientists have to try and predict in the spring what strains to include in the coming season’s flu vaccine. Sometimes they make a good match, but other times, like this year, the virus develops an unexpected mutation that helps it elude the vaccine’s protection. 

    Although this year’s flu vaccine doesn’t protect as well against the dominant subclade K strain, doctors still say that getting vaccinated is worthwhile.

    It can prevent severe disease and death and protects against other strains of the flu that are circulating. 

    How do scientists decide what goes in the flu vaccine? 

    There are two major types of influenza that circulate during flu season – influenza A and influenza B. Both can be further broken into subtypes, genetic clades and subclades that describe various different mutations of the virus. A clade is a group of organisms with a common ancestor. 

    Every year, the flu virus develops mutations to help it sneak past human immune systems. Each year, scientists try to predict, months in advance, what those mutations might be and which strains will circulate in the coming flu season. 

    The vaccine formula has to be decided far ahead of the fall flu season so there is time for manufacturing and distribution.

     “We do all that we can to predict which strains will predominate, but occasionally, strains emerge that are more divergent from what we predicted,” said Dr. Buddy Creech, director of the Vanderbilt Vaccine Research Program. “That’s the story of this year.”

    Why doesn’t the vaccine match? 

    This year’s vaccine protected against three different strains — two strains of influenza A (subtypes H1N1 and H3N2) and a strain of influenza B (Victoria lineage). 

    But after the Food and Drug Administration had decided on a formulation in March, the influenza A (H3N2) strain began to mutate.

    “This happens almost every two years with one or more of the three vaccine strains,” said Andrew Pekosz, a molecular microbiology and immunology professor at Johns Hopkins University. “While the vaccine gets ‘locked in,’ the virus still circulates in humans and continues to mutate, resulting in the ‘mismatch.’”

    The new subclade K strain only became the dominant strain after the vaccine formulation was decided.

    Does the vaccine still offer some protection? 

    Yes, and doctors say it is still worth getting if you haven’t yet. 

    “Even when the vaccine is not a perfect match to circulating strains, those who are vaccinated have lower rates of hospitalization and death,” said Dr. Caitlin Li, a pediatric infectious disease doctor at Lurie Children’s Hospital of Chicago. 

    Although there is a mismatch between the H3N2 strain the vaccine was formulated to protect against and the strain that is circulating among the public, that isn’t the case for the other two strains this year’s vaccine protects against — influenza A (H1N1) and influenza B, Pekosz told PolitiFact. 

    Getting vaccinated offers protection against the other two strains, which are still making people sick this year. “We often see a different influenza strain causing disease late in the influenza season,” Pekosz said. Future you might say thanks!

    It’s not too late to get vaccinated, Creech said, especially if you’re “at high risk for complications from infection.” 

    Why are people calling it the ‘super flu?’ 

    It’s catchy, but might be misleading. 

    “Right now, there is no data suggesting it’s either more severe or more contagious,” Pekosz said. But because the virus is better than usual at getting around the vaccine’s defenses, more people than usual are susceptible to infection.

    Lower than ideal flu vaccination rates, around 40% nationwide, may also be contributing to the intensity of this flu season.

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  • Flu cases in Tarrant County spike 256% as new variant spreads across Texas

    Influenza A virus.

    Influenza A virus.

    CDC

    If it feels like everyone around you is getting sick right now, you’re not imagining it.

    Texans are dealing with an early wave of fevers, body aches, and that wiped-out feeling that makes you want to stay in bed for days.

    The tricky part is that symptoms look a lot like COVID, allergies, or even just a bad cold, so people aren’t sure what they’ve actually caught.

    Doctors say the flu is the main illness showing up in clinics right now, and it’s spreading quicker than usual for this time of year.

    Here’s what to know about the variant that’s circulating and how to protect yourself from getting sick.

    🔥 In case you missed it…

    Which flu variant is spreading across Texas right now?

    Health officials say a new version of influenza A is driving the spike in sickness across Texas and the rest of the country right now.

    Tarrant County Public Health reported a 256 percent increase in flu positivity on rapid tests between Dec. 6 and Dec. 20, according to an alert Dec. 31. Hospital admissions for the flu also increased from 0.7 percent to 5.4 percent in that same span of time, TCPH said.

    Furthermore, national CDC data shows 8.1 percent of lab tests came back positive for flu in early December, and most of those samples were influenza A, specifically the H3N2 strain that doctors are seeing most this season.

    A newer offshoot of that strain, called subclade K, is showing up more often and may be part of the reason so many people are getting sick so quickly.

    Dr. Jeffrey Kahn, chief of infectious diseases at Children’s Health and pediatrics professor at UT Southwestern, told our news partners at WFAA that many patients go from “feeling well, and then six hours later you feel like you’ve been hit by a truck. You’ve got a high fever. You can’t get out of bed. It’s the worst feeling you’ve ever had in your life.”

    Which symptoms should I watch for this season?

    Experts say the most common signs include fever, chills, body aches, headaches, cough, congestion and that sudden wave of exhaustion that makes it hard to get out of bed.

    Many people also report feeling too weak or fatigued to keep up with daily routines.

    Some of these symptoms overlap with COVID and RSV, which is part of why people are confused about what they’ve actually caught.

    The CDC says you can’t always tell the difference based on symptoms alone, especially when fever and body aches are present. Testing is the only way to know for sure, and doctors say it can help guide treatment if symptoms get worse.

    How serious is the flu this season in Texas?

    Flu activity is higher than usual for this point in the winter, according to the Texas Department of State Health Services.

    More than 5,000 Texans visited hospitals or clinics for influenza like illness during the most recent reporting period, which is more than double what the state saw around this time last year.

    Influenza A is making up the majority of lab confirmed cases.

    The CDC reports that hospitalizations have also increased nationally, with adults 65 and older seeing the biggest jump in flu-related admissions.

    That trend mirrors what doctors in North Texas are seeing. Older adults, young children, and people with chronic health conditions remain at the highest risk for complications like pneumonia or dehydration.

    Although most people recover at home within several days, health officials urge Texans to take flu symptoms seriously.

    If you have trouble breathing, persistent chest pain, prolonged fever, or signs of dehydration, the CDC recommends seeking medical care right away.

    How can I protect myself from the flu?

    Doctors say consistent everyday habits are some of the most effective ways to avoid getting sick.

    According to the CDC, washing your hands often, using hand sanitizer when soap and water aren’t available, and cleaning high touch surfaces like phones, doorknobs, and countertops can help limit the spread of the virus.

    It also helps to avoid touching your eyes, nose, and mouth since flu viruses spread when people transfer germs from surfaces to their faces.

    If you’re feeling sick, the CDC recommends staying home until your fever has been gone for at least 24 hours without medication.

    Should I still get a flu shot if a new variant is spreading?

    Yes. The CDC says flu shots remain the best way to lower your chances of severe illness, even when a new version of the virus is circulating.

    This year’s vaccine targets three strains of flu, including two influenza A viruses and one influenza B virus.

    While the circulating subclade K strain has some differences from the virus used to design the shot, health officials say the vaccine can still help reduce symptoms and keep people out of the hospital.

    The CDC notes that it takes about two weeks for your body to build protection after getting vaccinated, so getting the shot now can still help as flu activity continues through the winter months.

    Vaccination is especially important for adults 65 and older, young children, pregnant people and anyone with underlying conditions.

    Where can I get a low-cost or free flu shot in Texas?

    Most major pharmacies offer flu shots at no cost with insurance, according to the CDC.

    Places like CVS, Walgreens, HEB, Kroger and Walmart usually take walk-ins, and many clinics allow you to book appointments online.

    If you don’t have insurance, you still have options. Local health departments often provide low-cost flu shots for adults, and some community clinics offer them for free during the winter months.

    You can call your county health department or check their website to see where walk in or low cost vaccination events are happening.

    This story was originally published December 31, 2025 at 11:29 AM.

    Related Stories from Fort Worth Star-Telegram

    Tiffani Jackson

    Fort Worth Star-Telegram

    Tiffani is a service journalism reporter for the Fort Worth Star-Telegram. She is part of a team of local journalists who answer reader questions about life in North Texas. Tiffani mainly writes about Texas laws and health news.

    Tiffani Jackson

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  • California braces for early, sharper flu season as virus mutation outpaces vaccine, experts say

    California could see an early start to the annual flu season, as a combination of low vaccination rates and late mutations to the virus may leave the state particularly exposed to transmission, health experts say.

    Already, there are warning signs. Los Angeles County recently reported its first flu death of the season, and other nations are reporting record-breaking or powerful, earlier-than-expected flu seasons.

    Typically, flu picks up right after Christmas and into the New Year, but Dr. Elizabeth Hudson, regional physician chief of infectious diseases at Kaiser Permanente Southern California, said she expects increases in viral activity perhaps over the next two to three weeks.

    “We’re expecting an early and likely sharp start to the flu season,” Hudson said.

    Last year’s flu season was the worst California had seen in years, and it’s not usual for there to be back-to-back bad flu seasons. But a combination of a decline in flu vaccination rates and a “souped-up mutant” is particularly concerning this year, according to Dr. Peter Chin-Hong, an infectious diseases expert at UC San Francisco.

    “That may translate into more people getting infected. And as more people get infected, a proportion of them will go to the hospital,” Chin-Hong said.

    The timing of this new flu subvariant — called H3N2 subclade K — is particularly problematic. It emerged toward the end of the summer, long after health officials had already determined how to formulate this fall’s flu vaccine, a decision that had to be made in February.

    H3N2 subclade K seems to be starting to dominate in Japan and Britain, Hudson said.

    “It looks like a bit of a mismatch between the seasonal flu vaccine strains” and the new subvariant, Hudson said.

    It remains unclear whether subclade K will reduce the effectiveness of this year’s flu shot.

    In California and the rest of the U.S., “things are quiet, but I think it’s just a calm before the storm,” Chin-Hong said. “From what we see in the U.K. and Japan, a lot more people are getting flu earlier.”

    Chin-Hong noted that subclade K is not that much different than the strains this year’s flu vaccines were designed against. And he noted data recently released in Britain that showed this season’s vaccines were still effective against hospitalization.

    According to the British government, vaccinated children were 70% to 75% less likely to need hospital care, and adults were 30% to 40% less likely. Flu vaccine effectiveness is typically between 30% to 60%, and tends to be more effective in younger people, the British government said.

    Even if there is some degree of mismatch between the vaccine and circulating strains, “the flu vaccine still provides protection against severe illness, including hospitalizations,” according to the Los Angeles County Department of Public Health.

    “Public Health strongly encourages everyone who has not received the flu vaccine yet this year to receive it now, especially before gathering with loved ones during the holidays,” the department said in a statement.

    But “while mismatched vaccines may still provide protection, enhanced genetic, antigenic and epidemiological … monitoring are warranted to inform risk assessment and response,” according to scientists writing in the Journal of the Assn. of Medical Microbiology and Infectious Diseases Canada.

    Because the vaccine is not a perfect match for the latest mutated flu strain, Chin-Hong said getting antiviral medication like Tamiflu to infected patients may be especially important this year, even for those who are vaccinated. That’s especially true for the most vulnerable, which include the very young and very old.

    “But that means you need to get diagnosed earlier,” Chin-Hong said. Drugs like Tamiflu work best when started within one to two days after flu symptoms begin, the U.S. Centers for Disease Control and Prevention says.

    There are now at-home flu testing kits that are widely available for sale for people who are showing signs of illness.

    Also worrying is how the flu has surged in other countries.

    Australia’s flu season came earlier this year and was more severe than usual. The Royal Australian College of General Practitioners said that nation saw a record flu season, with more than 410,000 lab-confirmed cases, up from the prior all-time high of 365,000 that were reported last year.

    “This is not a record we want to be breaking,” Dr. Michael Wright, president of the physician’s group, said.

    Hudson noted Australia’s flu season was “particularly hard on children” this year.

    L.A. County health officials cautioned that Australia’s experience isn’t a solid predictor of what happens locally.

    “It is difficult to predict what will happen in the United States and Los Angeles, as the severity of the flu season depends on multiple factors including circulating strains, pre-existing immunity, vaccine uptake, and the overall health of the population,” the L.A. County Department of Public Health said.

    The new strain has also thrown a wrench in things. As Australia’s flu season was ending, “this new mutation came up, which kind of ignited flu in Japan and the U.K., and other parts of Europe and Asia,” Chin-Hong said.

    On Friday, Japan reportedly issued a national alert with flu cases surging and hospitalizations increasing, especially among children and the elderly, accompanied by a sharp rise in school and class closures. The Japanese newspaper Asahi Shimbun said children ages 1 through 9 and adults 80 and up were among the hardest-hit groups.

    Taiwanese health officials warned of the possibility of a second peak in flu this year, according to the Central News Agency. There was already a peak in late September and early October — a month earlier than normal — and officials are warning about an uptick in flu cases starting in December and then peaking around the Lunar New Year on Feb. 17.

    Taiwanese officials said 95% of patients with severe flu symptoms had not been recently vaccinated.

    British health officials this month issued a “flu jab SOS,” as an early wave struck the nation. Flu cases are “already triple what they were this time last year,” Public Health Minister Ashley Dalton said in a statement.

    In England, outside of pandemic years, this fall marked the earliest start to the flu season since 2003-04, scientists said in the journal Eurosurveillance.

    “We have to brace ourselves for another year of more cases of flu,” Chin-Hong said.

    One major concern has been declining flu vaccination rates — a trend seen in both Australia and the United States.

    In Australia, only 25.7% of children age 6 months to 5 years were vaccinated against flu in 2025, the lowest rate since 2021. Among seniors age 65 and up, 60.5% were vaccinated, the lowest rate since 2020.

    Australian health officials are promoting free flu vaccinations for children that don’t require an injection, but are administered by nasal spray.

    “We must boost vaccination rates,” Wright said.

    In the U.S., officials recommend the annual flu vaccine for everyone age 6 months and up. Those age 65 and up are eligible for a higher-dose version, and kids and adults between age 2 and age 49 are eligible to get vaccinated via the FluMist nasal spray, rather than a needle injection.

    Officials this year began allowing people to order FluMist to be mailed to them at home.

    Besides getting vaccinated, other ways to protect yourself against the flu include washing your hands frequently, avoiding sick people and wearing a mask in higher-risk indoor settings, such as while in the airport and on a plane.

    Healthy high-risk people, such as older individuals, can be prescribed antiviral drugs like Tamiflu if another household member has the flu, Chin-Hong said.

    Doctors are especially concerned about babies, toddlers and young children up to age 5.

    “Those are the kids that are the most vulnerable if they get any kind of a respiratory illness. It can really go badly for them, and they can end up extraordinarily ill,” Hudson said.

    In the United States, just 49.2% of children had gotten a flu shot as of late April, lower than the 53.4% who had done so at the same point the previous season, according to preliminary national survey results. Both figures are well below the final flu vaccination rate for eligible children during the 2019-20 season, which was 63.7%.

    Among adults, 46.7% had gotten their flu shot as of late April, slightly down from the 47.4% at the same point last season, according to the preliminary survey results, which are the most recent data available.

    “Before the COVID-19 pandemic, flu vaccination coverage had been slowly increasing; downturns in coverage occurred during and after the pandemic. Flu vaccination levels have not rebounded to pre-pandemic levels,” according to the CDC.

    The disparaging of vaccinations by federal health officials, led by the vaccine-skeptic secretary of the U.S. Department of Health and Human Services, Robert F. Kennedy Jr., has not helped improve immunization rates, health experts say. Kennedy told the New York Times on Thursday that he personally directed the CDC to change its website to abandon its position that vaccines do not cause autism.

    Mainstream health experts and former CDC officials denounced the change. “Extensive scientific evidence shows vaccines do not cause autism,” wrote Daniel Jernigan, Demetre Daskalakis and Debra Houry, all former top officials at the CDC, in an op-ed to MS NOW.

    “CDC has been updated to cause chaos without scientific basis. Do not trust this agency,” Daskalakis, former director of the CDC’s National Center for Immunization and Respiratory Diseases, added on social media. “This is a national embarrassment.”

    State health officials from California, Washington, Oregon and Hawaii on Friday called the new claims on the CDC website inaccurate and said there are decades of “high quality evidence that vaccines are not linked to autism.”

    “Over 40 high-quality studies involving more than 5.6 million children have found no link between any routine childhood vaccine and autism,” the L.A. County Department of Public Health said Friday. “The increase in autism diagnoses reflects improved screening, broader diagnostic criteria, and greater awareness, not a link to vaccines.”

    Hudson said it’s important to get evidence-based information on the flu vaccines.

    “Vaccines save lives. The flu vaccine in particular saves lives,” Hudson said.

    Rong-Gong Lin II

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  • A new virus variant and lagging vaccinations may mean the US is in for a severe flu season

    The United States may be heading into its second severe flu season in a row, driven by a mutated strain called subclade K that’s behind early surges in the United Kingdom, Canada and Japan.Last winter’s season was extreme, too. The U.S. had its highest rates of flu hospitalizations in nearly 15 years. At least 280 children died of influenza, the highest number since pediatric death numbers were required to be shared in 2004.Now, with a new variant in the mix, experts say we’re on track for a repeat. And with flu vaccinations down and holiday travel on the way, they worry that things may look much worse in the weeks ahead.The good news: Early analysis shows that this season’s flu shots offer some protection against being hospitalized with this variant, especially for kids. The bad news is that many Americans appear to be skipping their flu vaccines this year. New data from prescription data company IQVIA shows that vaccinations are down compared to where they usually are at this point in the year.A new playerFlu activity is low but rising quickly in the United States, according to the latest FluView report from the U.S. Centers for Disease Control and Prevention.Most of the flu viruses identified this season have been an A strain called H3N2, and half of those have come from subclade K, a variant that was responsible for a rougher-than-normal flu season this summer in the Southern Hemisphere.That variant wasn’t a major player when scientists decided which strains should be in the annual flu shots, so the vaccines cover a related but slightly different group of viruses.”It’s not like we’re expecting to get complete loss of protection for the vaccine, but perhaps we might expect a little bit of a drop-off if this is the virus that sort of dominates the season, and early indications are that’s probably going to be the case,” said Dr. Richard Webby, director of the World Health Organization Collaborating Center for studies on the ecology of influenza in animals and birds at St. Jude Children’s Research Hospital.Early analysis by the U.K. Health Security Agency shows that subclade K has seven gene changes on a key segment of the virus. Those mutations change the shape of this region, making it harder for the body’s defenses to recognize.”That’s the predominant thing that our immune system targets with antibodies, and that’s also pretty much what’s in the vaccine,” said Dr. Adam Lauring, chief of the Division of Infectious Diseases at the University of Michigan Medical School.UKHSA scientists found that the current flu vaccines are still providing decent protection against subclade K viruses. Vaccination cut the odds of an emergency department visit or hospitalization for the flu by almost 75% in children. The effectiveness for adults, even those over 65, was lower, about 30% to 40% against needing to visit the hospital or ER.But the scientists offer a caveat: These results are from early in the season, before the protection from seasonal flu vaccines has had time to wane or wear off. The findings are posted in a recent preprint study, which means it was published ahead of scrutiny from outside experts.Still, some protection is better than no protection, and while subclade K is expected to dominate the season, it won’t be the only flu strain circulating. No one gets to pick what they’re exposed to. Lauring said his daughter has just recovered from the flu, but it was a B-type strain.At the same time this new variant has emerged, flu vaccinations appear to be down in the U.S. According to IQVIA, about 64% of all flu vaccinations were administered at retail pharmacies, which administered roughly 26.5 million flu shots between August and the end of October. That’s more than 2 million fewer shots than the 28.7 million given over the same time frame in 2024.”I’m not surprised,” said Dr. Jennifer Nuzzo, who directs the Pandemic Center at Brown University’s School of Public Health. Vaccine skepticism expressed by leaders of the US Department of Health and Human Services has “injected chaos into the whole vaccination system,” she said.”There’s been a lot of attention on really non-issues,” like vaccine ingredients and separating shots, that she thinks “at the best, left people confused but possibly at the worst have left people worried about getting vaccinated,” she added.Flu vaccinations have also fallen in Australia, where subclade K was the predominant virus this year. As a result, flu hit a record, with more than 443,000 cases. Flu season in the Southern Hemisphere typically runs from May to July, so infectious disease experts often look to those countries for a preview of what might be on the way to North America.”What they saw in Australia is that they had a bad season. And so it’s concerning for you and us, what’s coming,” said Dr. Earl Rubin, director of the infectious disease division at the Montreal Children’s Hospital in Canada.’This is the time we start to see the rise’It’s difficult to say whether subclade K actually makes a person sicker than other flu strains, but if it drives more cases, it will certainly drive hospitalizations too, Rubin said.”When you look at severity, the more cases you have, if the same percentage get hospitalized, obviously you’re going to have more hospitalization if you have more cases. So it sometimes will look like the severity is also worse,” he said.Lab testing data has begun to show an uptick in flu cases.”This is the time we start to see the rise,” said Dr. Allison McMullen, a clinical microbiologist at BioMerieux, which makes the BioFire test, a popular diagnostic tool for respiratory pathogens.The company anonymously compiles its test results into a syndromic surveillance tool, which can offer a glimpse of what bugs are making people sick at any given time. At the beginning of the month, less than 1% of tests were positive for type A flu. Now it’s 2.4% – still low numbers but going up briskly, which aligns with the CDC trend.”We’re going to start seeing heavy holiday travel before we know it,” McMullen added. “With the rising cases that we’re seeing the U.K. and Japan, it can definitely be a bellwether for what we’re going to see in North America.”Signals are also rising in wastewater, said Dr. Marlene Wolfe, an assistant professor of environmental health at Emory University. In October, 18% of samples in the WastewaterSCAN network — an academically led wastewater monitoring program based at Stanford University, in partnership with Emory — were positive for type A flu, Wolfe said. In November, that number had risen to 40%.”Flu is something where, when it’s not in season, we don’t detect it very frequently in wastewater,” Wolfe said. COVID, on the other hand, can be detected pretty much all the time, which makes it challenging to know if it’s going up or down, she said.The scientists can set a threshold for when they can declare that a specific area is in flu season, Wolfe says. So far, just four of the 147 sites they monitor in 40 states have reached that threshold. Those sites are in the Northeast — in Maine and Vermont — in Iowa and in Hawaii.”I am concerned, I guess, that we could have a big flu season this year based on what we’re seeing in other parts of the world, and particularly Europe and elsewhere,” Michigan’s Lauring said.”It’s not too late. Go and get your flu shot,” Lauring advised. “And be alert that it’s out there.”

    The United States may be heading into its second severe flu season in a row, driven by a mutated strain called subclade K that’s behind early surges in the United Kingdom, Canada and Japan.

    Last winter’s season was extreme, too. The U.S. had its highest rates of flu hospitalizations in nearly 15 years. At least 280 children died of influenza, the highest number since pediatric death numbers were required to be shared in 2004.

    Now, with a new variant in the mix, experts say we’re on track for a repeat. And with flu vaccinations down and holiday travel on the way, they worry that things may look much worse in the weeks ahead.

    The good news: Early analysis shows that this season’s flu shots offer some protection against being hospitalized with this variant, especially for kids. The bad news is that many Americans appear to be skipping their flu vaccines this year. New data from prescription data company IQVIA shows that vaccinations are down compared to where they usually are at this point in the year.

    A new player

    Flu activity is low but rising quickly in the United States, according to the latest FluView report from the U.S. Centers for Disease Control and Prevention.

    Most of the flu viruses identified this season have been an A strain called H3N2, and half of those have come from subclade K, a variant that was responsible for a rougher-than-normal flu season this summer in the Southern Hemisphere.

    That variant wasn’t a major player when scientists decided which strains should be in the annual flu shots, so the vaccines cover a related but slightly different group of viruses.

    “It’s not like we’re expecting to get complete loss of protection for the vaccine, but perhaps we might expect a little bit of a drop-off if this is the virus that sort of dominates the season, and early indications are that’s probably going to be the case,” said Dr. Richard Webby, director of the World Health Organization Collaborating Center for studies on the ecology of influenza in animals and birds at St. Jude Children’s Research Hospital.

    Early analysis by the U.K. Health Security Agency shows that subclade K has seven gene changes on a key segment of the virus. Those mutations change the shape of this region, making it harder for the body’s defenses to recognize.

    “That’s the predominant thing that our immune system targets with antibodies, and that’s also pretty much what’s in the vaccine,” said Dr. Adam Lauring, chief of the Division of Infectious Diseases at the University of Michigan Medical School.

    UKHSA scientists found that the current flu vaccines are still providing decent protection against subclade K viruses. Vaccination cut the odds of an emergency department visit or hospitalization for the flu by almost 75% in children. The effectiveness for adults, even those over 65, was lower, about 30% to 40% against needing to visit the hospital or ER.

    But the scientists offer a caveat: These results are from early in the season, before the protection from seasonal flu vaccines has had time to wane or wear off. The findings are posted in a recent preprint study, which means it was published ahead of scrutiny from outside experts.

    Still, some protection is better than no protection, and while subclade K is expected to dominate the season, it won’t be the only flu strain circulating. No one gets to pick what they’re exposed to. Lauring said his daughter has just recovered from the flu, but it was a B-type strain.

    At the same time this new variant has emerged, flu vaccinations appear to be down in the U.S. According to IQVIA, about 64% of all flu vaccinations were administered at retail pharmacies, which administered roughly 26.5 million flu shots between August and the end of October. That’s more than 2 million fewer shots than the 28.7 million given over the same time frame in 2024.

    “I’m not surprised,” said Dr. Jennifer Nuzzo, who directs the Pandemic Center at Brown University’s School of Public Health. Vaccine skepticism expressed by leaders of the US Department of Health and Human Services has “injected chaos into the whole vaccination system,” she said.

    “There’s been a lot of attention on really non-issues,” like vaccine ingredients and separating shots, that she thinks “at the best, left people confused but possibly at the worst have left people worried about getting vaccinated,” she added.

    Flu vaccinations have also fallen in Australia, where subclade K was the predominant virus this year. As a result, flu hit a record, with more than 443,000 cases. Flu season in the Southern Hemisphere typically runs from May to July, so infectious disease experts often look to those countries for a preview of what might be on the way to North America.

    “What they saw in Australia is that they had a bad season. And so it’s concerning for you and us, what’s coming,” said Dr. Earl Rubin, director of the infectious disease division at the Montreal Children’s Hospital in Canada.

    ‘This is the time we start to see the rise’

    It’s difficult to say whether subclade K actually makes a person sicker than other flu strains, but if it drives more cases, it will certainly drive hospitalizations too, Rubin said.

    “When you look at severity, the more cases you have, if the same percentage get hospitalized, obviously you’re going to have more hospitalization if you have more cases. So it sometimes will look like the severity is also worse,” he said.

    Lab testing data has begun to show an uptick in flu cases.

    “This is the time we start to see the rise,” said Dr. Allison McMullen, a clinical microbiologist at BioMerieux, which makes the BioFire test, a popular diagnostic tool for respiratory pathogens.

    The company anonymously compiles its test results into a syndromic surveillance tool, which can offer a glimpse of what bugs are making people sick at any given time. At the beginning of the month, less than 1% of tests were positive for type A flu. Now it’s 2.4% – still low numbers but going up briskly, which aligns with the CDC trend.

    “We’re going to start seeing heavy holiday travel before we know it,” McMullen added. “With the rising cases that we’re seeing the U.K. and Japan, it can definitely be a bellwether for what we’re going to see in North America.”

    Signals are also rising in wastewater, said Dr. Marlene Wolfe, an assistant professor of environmental health at Emory University. In October, 18% of samples in the WastewaterSCAN network — an academically led wastewater monitoring program based at Stanford University, in partnership with Emory — were positive for type A flu, Wolfe said. In November, that number had risen to 40%.

    “Flu is something where, when it’s not in season, we don’t detect it very frequently in wastewater,” Wolfe said. COVID, on the other hand, can be detected pretty much all the time, which makes it challenging to know if it’s going up or down, she said.

    The scientists can set a threshold for when they can declare that a specific area is in flu season, Wolfe says. So far, just four of the 147 sites they monitor in 40 states have reached that threshold. Those sites are in the Northeast — in Maine and Vermont — in Iowa and in Hawaii.

    “I am concerned, I guess, that we could have a big flu season this year based on what we’re seeing in other parts of the world, and particularly Europe and elsewhere,” Michigan’s Lauring said.

    “It’s not too late. Go and get your flu shot,” Lauring advised. “And be alert that it’s out there.”

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  • Doctor explains a rare but serious condition associated with the flu

    We all know that influenza is a common and serious viral infection, but it’s good to be reminded ahead of the upcoming flu season, which typically starts in October.Related video above: How the new at-home flu vaccine worksThere were an estimated 47 million to 82 million flu illnesses in the United States between October 2024 and May 2025, resulting in between 610,000 and 1.3 million hospitalizations, according to preliminary estimated ranges from the U.S. Centers for Disease Control and Prevention.Most fatalities occur in older individuals, but children can also die from the flu. The CDC estimates that flu-related deaths in children have generally ranged from 37 to 199 deaths each flu season.Now, a new study in JAMA has examined a rare but severe complication that can occur in children who contract the flu. This complication, called acute necrotizing encephalopathy, or ANE, carries a mortality rate of 27% despite intensive care and treatment, according to the new research.I wanted to learn more about complications associated with the flu, specifically about ANE, what researchers learned about children with ANE, and how ANE can be prevented. And what should parents and families know ahead of the next flu season?To help with these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and clinical associate professor at George Washington University. She previously was Baltimore’s health commissioner.CNN: What are complications associated with the flu? Who is most at risk?Dr. Leana Wen: Most people who have the flu will recover without complications. They may go through days or even weeks having fever, runny nose, headache and fatigue, but these symptoms generally resolve without long-term consequences.Some people, though, experience complications that could result in severe illness or even death. These complications include pneumonia, sinus and ear infections, brain and neurological conditions, and the worsening of existing medical problems such as heart and kidney disease.People at higher risk for flu complications include people 65 years and older, children younger than 2 and pregnant women. In addition, there are a variety of chronic medical conditions that increase risk, including chronic lung disease, diabetes, heart disease, liver disorders, kidney dysfunction and any condition that makes you immunocompromised.CNN: What exactly is ANE, and how common is it?Wen: ANE is a rare but very serious condition that occurs as a result of influenza infection. It causes inflammation and swelling in the brain, and it can lead to seizures, impaired consciousness, coma, long-term brain damage and death.It’s not known precisely how common this condition is or whether the incidence has been changing in recent years. It can also occur after other viral illnesses, but it has been most closely associated with influenza, and most often in children.CNN: What did researchers in this study find out about children with ANE?Wen: They sought information from U.S. pediatric hospitals and public health agencies regarding cases of pediatric ANE treated between October 2023 and May 2025. In total, they included 41 children with influenza-related ANE.The median age of these children was 5, and about 3 out of 4 were previously healthy. Importantly, just 16% of those for whom vaccination history was available had received the flu vaccine that season.All these patients became very ill, and all developed encephalopathy, or altered brain function. Sixty-eight percent had seizures. Most had abnormalities in their platelet count, liver enzymes and spinal fluid composition.Most patients received a combination of therapies, including steroids and immunoglobulins. Out of 41 patients in the analysis, 11 died. The median period between symptom onset and death was just three days; most of the children who died had such severe brain swelling that the pressure forced the brain downward, crushing vital areas that control breathing and heart function. All but one of the children who died had not received the latest flu vaccine. Among the survivors included in the analysis, 63% had at least moderate disability.The first takeaway for me is that ANE, while rare, is extremely serious, with high morbidity and mortality. It can be deadly within a short period of time, which means prompt diagnosis and treatment are essential. Second, most children with ANE were previously healthy. Third, while some vaccinated children also became ill, most of those with ANE and nearly all of those who died had not received the flu vaccine that season.CNN: How can ANE be prevented?Wen: It is not known why most people who contract flu never develop ANE, but some do. It’s also not known whether there is anything that can be done once someone contracts the flu to prevent ANE.What is known is that getting the flu vaccine reduces the chance of contracting the flu and of becoming severely ill as a result. This JAMA study also suggests that vaccination reduces the likelihood of developing ANE and of dying from it. The article and an accompanying editorial emphasize the importance of everyone being up-to-date with the flu vaccine.CNN: What else should parents and families know ahead of the next flu season?Wen: Influenza is a common illness that can have serious complications, including in previously healthy individuals. Getting the flu vaccine is helpful both for reducing the chance of contracting the flu and for lowering the likelihood of developing complications. The CDC recommends the flu vaccine for virtually everyone 6 months and older. Parents should be sure that their children receive the flu vaccine in the fall and that they and others in the family are vaccinated, too.Of course, flu is not the only contagious respiratory illness that can spread in fall and winter months. It’s important for people who have fever and active respiratory symptoms to stay away from others, especially those most vulnerable to severe illness. Good hand hygiene can lower the risk of spreading contagious diseases, as can taking precautions like masking in indoor crowded settings.

    We all know that influenza is a common and serious viral infection, but it’s good to be reminded ahead of the upcoming flu season, which typically starts in October.

    Related video above: How the new at-home flu vaccine works

    There were an estimated 47 million to 82 million flu illnesses in the United States between October 2024 and May 2025, resulting in between 610,000 and 1.3 million hospitalizations, according to preliminary estimated ranges from the U.S. Centers for Disease Control and Prevention.

    Most fatalities occur in older individuals, but children can also die from the flu. The CDC estimates that flu-related deaths in children have generally ranged from 37 to 199 deaths each flu season.

    Now, a new study in JAMA has examined a rare but severe complication that can occur in children who contract the flu. This complication, called acute necrotizing encephalopathy, or ANE, carries a mortality rate of 27% despite intensive care and treatment, according to the new research.

    I wanted to learn more about complications associated with the flu, specifically about ANE, what researchers learned about children with ANE, and how ANE can be prevented. And what should parents and families know ahead of the next flu season?

    To help with these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and clinical associate professor at George Washington University. She previously was Baltimore’s health commissioner.

    CNN: What are complications associated with the flu? Who is most at risk?

    Dr. Leana Wen: Most people who have the flu will recover without complications. They may go through days or even weeks having fever, runny nose, headache and fatigue, but these symptoms generally resolve without long-term consequences.

    Some people, though, experience complications that could result in severe illness or even death. These complications include pneumonia, sinus and ear infections, brain and neurological conditions, and the worsening of existing medical problems such as heart and kidney disease.

    People at higher risk for flu complications include people 65 years and older, children younger than 2 and pregnant women. In addition, there are a variety of chronic medical conditions that increase risk, including chronic lung disease, diabetes, heart disease, liver disorders, kidney dysfunction and any condition that makes you immunocompromised.

    CNN: What exactly is ANE, and how common is it?

    Wen: ANE is a rare but very serious condition that occurs as a result of influenza infection. It causes inflammation and swelling in the brain, and it can lead to seizures, impaired consciousness, coma, long-term brain damage and death.

    It’s not known precisely how common this condition is or whether the incidence has been changing in recent years. It can also occur after other viral illnesses, but it has been most closely associated with influenza, and most often in children.

    CNN: What did researchers in this study find out about children with ANE?

    Wen: They sought information from U.S. pediatric hospitals and public health agencies regarding cases of pediatric ANE treated between October 2023 and May 2025. In total, they included 41 children with influenza-related ANE.

    The median age of these children was 5, and about 3 out of 4 were previously healthy. Importantly, just 16% of those for whom vaccination history was available had received the flu vaccine that season.

    All these patients became very ill, and all developed encephalopathy, or altered brain function. Sixty-eight percent had seizures. Most had abnormalities in their platelet count, liver enzymes and spinal fluid composition.

    Most patients received a combination of therapies, including steroids and immunoglobulins. Out of 41 patients in the analysis, 11 died. The median period between symptom onset and death was just three days; most of the children who died had such severe brain swelling that the pressure forced the brain downward, crushing vital areas that control breathing and heart function.

    All but one of the children who died had not received the latest flu vaccine. Among the survivors included in the analysis, 63% had at least moderate disability.

    The first takeaway for me is that ANE, while rare, is extremely serious, with high morbidity and mortality. It can be deadly within a short period of time, which means prompt diagnosis and treatment are essential. Second, most children with ANE were previously healthy. Third, while some vaccinated children also became ill, most of those with ANE and nearly all of those who died had not received the flu vaccine that season.

    CNN: How can ANE be prevented?

    Wen: It is not known why most people who contract flu never develop ANE, but some do. It’s also not known whether there is anything that can be done once someone contracts the flu to prevent ANE.

    What is known is that getting the flu vaccine reduces the chance of contracting the flu and of becoming severely ill as a result. This JAMA study also suggests that vaccination reduces the likelihood of developing ANE and of dying from it. The article and an accompanying editorial emphasize the importance of everyone being up-to-date with the flu vaccine.

    CNN: What else should parents and families know ahead of the next flu season?

    Wen: Influenza is a common illness that can have serious complications, including in previously healthy individuals. Getting the flu vaccine is helpful both for reducing the chance of contracting the flu and for lowering the likelihood of developing complications. The CDC recommends the flu vaccine for virtually everyone 6 months and older. Parents should be sure that their children receive the flu vaccine in the fall and that they and others in the family are vaccinated, too.

    Of course, flu is not the only contagious respiratory illness that can spread in fall and winter months. It’s important for people who have fever and active respiratory symptoms to stay away from others, especially those most vulnerable to severe illness. Good hand hygiene can lower the risk of spreading contagious diseases, as can taking precautions like masking in indoor crowded settings.

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  • What women should know about Medicare coverage for health screenings and exams

    What women should know about Medicare coverage for health screenings and exams

    As women get older, our risk for certain chronic diseases increase. We can thank the aging process itself, and the loss of estrogen’s protective effects after menopause. Older women are more prone to conditions like osteoporosis, which can cause brittle bones. The chance of heart disease rises, as do the odds of developing dementia, in part because women tend to live longer than men, and risk increases with age.

    Diagnosing some conditions is more challenging, since the frequency, appearance and long term effects of many diseases often appear differently in women than in men. It’s a key reason not to neglect regular health screenings and wellness visits, since staying healthier through preventive care and screenings can make the health challenges of aging easier.

    Wellness exams are critical for older women

    Medicare pays for annual preventive care with no co-pay. That’s especially relevant for women, who made up more than half (55%) of all Medicare beneficiaries in 2021. Nearly 1 in 8 (12%) were 85 or older; many had functional difficulties, an analysis from KFF found. That included difficulty walking, bathing, vision loss, or other issues that significantly impacted their quality of life. People age 85 and older tend to have five or more chronic conditions, which can become more complicated to manage with age.

    Women know they should focus on their health, says Alina Salganicoff, director of women’s health policy at KFF. But, “sometimes the system is not set up for women to take care of themselves, because they have competing demands, like work, or family caregiving responsibilities.” This often creates limited windows of time for women to prioritize themselves.

    And, if women don’t have access to a primary care provider or don’t receive regular care, they could skip important preventive measures like mammograms, she says.

    “Having coverage is the first step, but many other factors affect whether women get the services they need,” Salganicoff says. That includes their relationships with their clinicians, their own prior experiences, access to care, fears about conditions like dementia or cancer, or social supports like transportation, mobility or cognitive issues, or having someone to accompany them.

    That first wellness visit is probably key to everything else in managing an older patient, according to Segen Chase, an internal medicine physician in private practice in Manhattan, Kansas. About 35% of her clinic’s patients are Medicare beneficiaries, including many who live at a nearby retirement community.

    “It’s so important that we will do anything we can to have them visit and work with the practice’s wellness coordinator to go through all of the needed assessments,” said Chase, who is part of the American Medical Women’s WEL leadership training program.

    Wellness exams include annual tracking of numerous behavioral and physical markers like vision, hearing, fall risk, sexual health, nutrition, alcohol and tobacco use, as well as psychosocial risks like depression, stress, loneliness or social isolation, pain, and fatigue. Patients also undergo cognitive screening, which can reveal subtle changes in brain health.

    Wellness screenings may also include questions about someone’s living situation, because it helps us to determine whether they might need additional help at home, Chase says. “That also gives us an opportunity to discuss advance care planning, when they’re not in a crisis situation.” Medicare pays for this as part of the Part B annual wellness visit.

    Women with Medicare overall experience higher rates of certain health conditions compared to men, according to the KFF analysis. Urinary incontinence (37% vs. 18%), depression (31% vs. 21%), osteoporosis (29% vs. 7%), and pulmonary disease (20% vs. 16%) were more common among women than men. Women are also more likely than men to live alone. More than one-third of all women with Medicare (36%) live by themselves and more than half of those 85 and older live solo. This can increase the odds of  loneliness and social isolation, which are connected to increased risk of depression, dementia and stroke, according to the American Medical Association.

    The wellness visit can help uncover some of the hidden issues, and together, the physician and patient can create a care plan to manage these and other chronic conditions, Chase says.

    Which preventive women’s health services does Medicare cover?

    Medicare Part B covers a range of preventive services that benefit women’s health, including:

    There are no copays, deductibles or coinsurance charges for these and other covered screenings, although certain other criteria may apply, according to the Medicare Rights Center. Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) will even help pay for an osteoporosis injectable drug and visits by a home health nurse to inject the drug if you are eligible.

    This partial list of Medicare-covered screenings may seem daunting, which is why it’s so important for women to speak with their clinicians and discuss their health history, risk factors, and priorities, according to Salganicoff. “It’s a complicated program and can be difficult for people to navigate,” she says.

    These shouldn’t be one-off conversations, either, Chase says. As we age, priorities and what is realistic for a person to achieve may shift. So ongoing dialogue is a key to maintaining health.

    We know certain conditions show up differently in women, so “a lot of medicine comes back to communication, keeping the sanctity of the relationship while honoring their independence and finding out what’s most important to that person,” she says. Chase finds these discussions help women open up more about both their physical and emotional challenges, especially those who are caregivers. “They’re often exhausted but don’t want to admit it.”

    Providing women with clear, simple information so they can learn about all of their Medicare benefits and receive the necessary support to get the preventive care and other needed services, can go a long way towards keeping women healthy well into older age.

    Liz Seegert

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  • Flu Shots Need to Stop Fighting ‘Something That Doesn’t Exist’

    Flu Shots Need to Stop Fighting ‘Something That Doesn’t Exist’


    Listen to this article

    Produced by ElevenLabs and NOA, News Over Audio, using AI narration.

    In Arnold Monto’s ideal vision of this fall, the United States’ flu vaccines would be slated for some serious change—booting a major ingredient that they’ve consistently included since 2013. The component isn’t dangerous. And it made sense to use before. But to include it again now, Monto, an epidemiologist and a flu expert at the University of Michigan, told me, would mean vaccinating people “against something that doesn’t exist.”

    That probably nonexistent something is Yamagata, a lineage of influenza B viruses that hasn’t been spotted by global surveyors since March of 2020, shortly after COVID mitigations plummeted flu transmission to record lows. “And it isn’t for lack of looking,” Kanta Subbarao, the director of the WHO’s Collaborating Centre for Reference and Research on Influenza, told me. In a last-ditch attempt to find the missing pathogen, a worldwide network of monitoring centers tested nearly 16,000 influenza B virus samples collected from February to August of last year. Not a single one of them came up Yamagata. “The consensus is that it’s gone,” Cheryl Cohen, the head of South Africa’s Centre for Respiratory Diseases and Meningitis, told me. Officially removing an ingredient from flu vaccines will codify that sentiment, effectively publishing Yamagata’s obituary.

    Read: The flu may never be the same

    Last year around this time, Subbarao told me, the WHO was already gently suggesting that the world might want to drop Yamagata from vaccines; by September, the agency had grown insistent, describing the ingredient as “no longer warranted” and urging that “every effort should be made to exclude it as soon as possible.” The following month, an advisory committee to the FDA unanimously voted to speedily adopt that same change.

    But the switch from a four-flu vaccine to a trivalent one, guarding against only three, isn’t as simple as ordering the usual, please, just hold the Yams. Trivalent vaccines require their own licensure, which some manufacturers may have allowed to lapse—or never had at all; manufacturers must also adhere to the regulatory pipelines specific to each country. “People think, ‘They change the strains every season; this should be no big deal,’” Paula Barbosa, the associate director of vaccine policy at the International Federation of Pharmaceutical Manufacturers and Associations, which represents vaccine manufacturers, told me. This situation is not so simple: “They need to change their whole manufacturing process.” At the FDA advisory-committee meeting in October, an industry representative cautioned that companies might need until the 2025–26 season to fully transition to trivalents in the Northern Hemisphere, a timeline that Barbosa, too, considers realistic. The South could take until 2026.

    In the U.S., though, where experts such as Monto have been pushing for expedient change, a Yamagata-less flu vaccine could be coming this fall. When I reached out to CSL Seqirus and GSK, two of the world’s major flu-vaccine producers, a spokesperson from each company told me that their firm was on track to deliver trivalent vaccines to the U.S. in time for the 2024–25 flu season, should the relevant agencies recommend and request it. (The WHO’s annual meeting to recommend the composition of the Northern Hemisphere’s flu vaccine isn’t scheduled until the end of February; an FDA advisory meeting on the same topic will follow shortly after.) Sanofi, another vaccine producer, was less definitive, but told me that, with sufficient notice from health authorities, its plans would allow for trivalent vaccines this year, “if there is a definitive switch.” AstraZeneca, which makes the FluMist nasal-spray vaccine, told me that it was “engaging with the appropriate regulatory bodies” to coordinate the shift to a trivalent vaccine “as soon as possible.”

    Quadrivalent flu vaccines are relatively new. Just over a decade ago, the world relied on immunizations that included two flu A strains (H1N1 and H3N2), plus one B: either Victoria or Yamagata, whichever scientists predicted might be the bigger scourge in the coming flu season. “Sometimes the world got it wrong,” Mark Jit, an epidemiologist at the London School of Hygiene & Tropical Medicine, told me. To hedge their bets, experts eventually began to recommend simply sticking in both. But quadrivalent vaccines typically cost more to manufacture, experts told me. And although several countries, including the U.S., quickly transitioned to the heftier shots, many nations—especially those with fewer resources—never did.

    Now “the extra component is a waste,” Vijay Dhanasekaran, a virologist at the University of Hong Kong, told me. It’s pointless to ask people’s bodies to mount a defense against an enemy that will never attack. Trimming Yamagata out of flu-vaccine recipes should also make them cheaper, Dhanasekaran said, which could improve global access. Plus, continuing to manufacture Yamagata-focused vaccines raises the small but serious risk that the lineage could be inadvertently reintroduced to the world, Subbarao told me, as companies grow gobs of the virus for their production pipeline. (Some vaccines, such as FluMist, also immunize people with live-but-weakened versions of flu viruses.)

    Some of the researchers I spoke with for this article weren’t ready to rule out the possibility—however slim—that Yamagata is still biding its time somewhere. (Victoria, a close cousin of Yamagata, and the other B lineage that pesters people, once went mostly quiet for about a decade, before roaring back in the early aughts.) But most experts, at this point, are quite convinced. The past couple of flu seasons have been heavy enough to offer even a rather rare lineage the chance to reappear. “If it had been circulating in any community, I’m pretty sure that global influenza surveillance would have detected it by now,” Dhanasekaran said. Plus, even before the pandemic began, Yamagata had been the wimpiest of the flu bunch, Jit told me: slow to evolve, crummy at transmitting, and already dipping in prevalence. When responses to the pandemic starved all flu viruses of hosts, he said, this lineage was the likeliest to be lost.

    Read: The pandemic broke the flu

    Eventually, companies may return to including four types of flu in their products, swapping in, say, another strain of H3N2, the most severe and fastest-evolving of the bunch—a change that Subbarao and Monto both told me might actually be preferable. But incorporating a second H3N2 is even more of a headache than returning to a trivalent vaccine: Researchers would likely first need to run clinical trials, experts told me, to ensure that the new components played nicely with each other and conferred additional benefits.

    For the moment, a slimmed-down vaccine is the quickest way to keep up with the flu’s current antics. And in doing so, those vaccines will also reflect the strange reality of this new, COVID-modified world. “A whole lineage of flu has probably been eliminated through changes in human behavior,” Jit told me. Humanity may not have intended it. But our actions against one virus may have forever altered the course of another.



    Katherine J. Wu

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  • America Is Having a Senior Moment on Vaccines

    America Is Having a Senior Moment on Vaccines

    For years now, health experts have been warning that COVID-era politics and the spread of anti-vaxxer lies have brought us to the brink of public-health catastrophe—that a Great Collapse of Vaccination Rates is nigh. This hasn’t come to pass. In spite of deep concerns about a generation of young parents who might soon give up on immunizations altogether—not simply for COVID, but perhaps for all disease—many of the stats we have are looking good. Standard vaccination coverage among babies and toddlers, including the pandemic babies born in 2020, is “high and stable,” the CDC reports. And kindergarteners’ immunization rates, which dipped after the pandemic started, are no longer losing ground.

    Whatever gaps in early childhood vaccination were brought on by the chaos of early 2020 have since been reversed, Alison Buttenheim, a professor of nursing and health policy at the University of Pennsylvania, told me: “We’ve substantially caught up, which is incredible. It’s actually an amazing feat.”

    Read: The good news about vaccine hesitancy

    But even in the shadow of this triumph, a more specific crisis in vaccine acceptance has emerged. Americans aren’t now suspicious of inoculations on the whole—the nation isn’t anti-vax—but we have lost faith in yearly COVID shots. Barely any children have been getting them. Among adults, the drop in uptake has been rapid and relentless: By the spring of 2022, 56 percent of all adults had received their initial booster shot; a year later, just 28 percent were up to date; so far this COVID season, just 19 percent can say the same.

    Of course, the dangers from infection have been dropping too. Almost all of us have been exposed to COVID at this point, either through prior immunization, natural infection, or—most likely—both. That makes the disease much less deadly than it’s ever been before. (Among kids, the CDC now attributes “0.00%” of weekly deaths to COVID.) But for one age group in particular—people over 65—the crashing vaccination rates should inspire dread. More than 1,500 deaths each week are still associated with COVID, and almost all of them are senior citizens; current data hint that COVID has been killing seniors at seven times the rate of flu. Across the nation’s nursing homes and retirement communities, the Great Collapse is real.

    Like younger American adults, seniors haven’t been avoiding all recommended immunizations, just the ones for COVID. Their flu-shot rates have gone down a little in the past few years, but only by a handful of percentage points from a pandemic-driven, all-time high of 75 percent. This season, about 70 percent of people over 65 have received their flu vaccine, in line with average rates that haven’t changed that much for decades. In the meantime, seniors’ uptake of the latest COVID shots has fallen off by more than half since 2022, to just 38 percent. These diverging rates—steady for the flu, plummeting for COVID—are notably at odds with the attendant risks. Seniors seem to understand the value of inoculating themselves against the flu. So why do they forgo the same precaution against something so much worse?

    Read: The COVID strategy America hasn’t really tried

    One might blame the toxic political battles around vaccines, and rampant misinformation about their ill effects. “Something terrible has happened to broaden and intensify public rejection of vaccines and other biomedical innovations in the United States,” the vaccine expert Peter Hotez wrote in his recent book The Deadly Rise of Anti-science. Certainly, toxic politics and rampant misinformation exist, but the turn against the experts that Hotez and others have decried doesn’t really fit the emergency described above. Taken as a whole, the population of Americans over 65 is hardly soured on vaccines. Nor are they afraid of COVID vaccination in particular: Though political divides persist, more than 95 percent of seniors received their initial round of shots. More than 95 percent!

    Echoing Hotez in an opinion piece for JAMA that came out last week, the FDA commissioner, Robert Califf, and a senior FDA official named Peter Marks cited the abysmal uptake of COVID shots by senior citizens as one of several signs that the country is nearing “a dangerous tipping point” on vaccination, driven by an oceanic online tide of vaccine misinformation. (Health-care providers should try to stem that tide, they wrote, with “large amounts of truthful, accessible scientific evidence.”) But the volume and intensity of anti-vaccine rhetoric seems to have diminished somewhat since 2022, Buttenheim told me: “You’d have to come up with some reason why it’s having more of an effect now than it did over the past couple of years.”

    Confusion and fatigue may well be bigger factors here than fear or false beliefs. Many Americans, young and old, have long since moved beyond the pandemic in their daily life, and may not want to think about the topic long enough to schedule another shot. The fact that people are fed up with COVID and all of the arguments it spawned is a “major drag on uptake of the vaccine,” Noel Brewer, a professor who studies health behavior at the University of North Carolina at Chapel Hill, told me. Along with many other adults, seniors have also been thrown off by changes in what the shot is called and when it’s recommended for which groups. Buttenheim doesn’t think that people are particularly afraid of this year’s dose. “This is not, like, Back off,” she said. “It’s like, Oh, there is one?”

    Read: America’s fall booster plan has a fatal paradox

    Another theory holds that the CDC is responsible for this indifference, by pushing yearly COVID shots on people of all ages, including those for whom the net benefits of further vaccination are hard to see. In the U.K., where a much narrower group of people is eligible for updated COVID shots, uptake among seniors has been almost double what it is in the U.S., at 70 percent. That’s not because the British health-care system is better organized than ours—or not only on account of that. Even in that context, British seniors only get their flu shots at a rate that’s slightly higher than American seniors do.

    The broader rollout could contribute to the problem, Rupali Limaye, an epidemiologist who studies health communication at Johns Hopkins University, told me: “When it’s a blanket recommendation, it does dilute the message.” The CDC’s messaging on COVID shots has the benefit of being simple, but at the cost of being less persuasive for the people who are at highest risk. Then again, all Americans above the age of six months are advised to get the flu shot, and more or less the same proportions do so every year. That’s a product of our training, Brewer told me: “The U.S. has invested for decades in developing the habit of getting an annual flu shot. Older adults know that this is the thing they need to do, and they are used to it.”

    Even more important than the habit of getting flu shots is the habit of supplying them. Local clinics, businesses, and retirement communities know how to give these vaccinations (and they understand how the costs will be covered); they’ve been doing this for years. Buttenheim told me that her university sets up a flu-shot clinic every fall, where she can usually get immunized in less than 90 seconds. But the equivalent for COVID shots is yet to become routine. Where the vaccines are available, appointments have been canceled over missing doses or mix-ups with insurance. Government efforts to improve access were delayed.

    With the end of the pandemic emergency, obtaining a COVID shot has simply gotten harder, no matter your intentions or beliefs. “The very well-structured and scaffolded process for getting those vaccines before has just evaporated,” Buttenheim said. For the uptake rates to turn around, a new, post-emergency system for delivery might have to be established, with less confusion over cost and coverage. Even that development alone would do a lot to end the geriatric vaccine crash. If COVID shots could be made as standardized and reflexive as the ones for flu, seasonal vaccination rates might start rising once again, at least until about two-thirds of people over 65 are getting shots. That’s the rate we see for flu shots, and probably an upper limit, Brewer said: “We won’t do better than that.”

    Daniel Engber

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  • America’s COVID Booster Rates Are a Bad Sign for Winter

    America’s COVID Booster Rates Are a Bad Sign for Winter

    And just like that, with the passing of Labor Day, fall was upon us. Seemingly overnight, six-packs of pumpkin beer materialized on grocery shelves, hordes of city dwellers descended upon apple orchards—and America rolled out new COVID boosters. The timing wasn’t a coincidence. Since the beginning of the pandemic, cases in North America and Europe have risen during the fall and winter, and there was no reason to expect anything different this year. Spreading during colder weather is simply what respiratory diseases like COVID do. The hope for the fall booster rollout was that Americans would take it as an opportunity to supercharge their immunological defenses against the coronavirus in advance of a winter wave that we know is going to come.

    So far, reality isn’t living up to that hope. Since the new booster became available in early September, fewer than 20 million Americans have gotten the shot, according to the CDC—just 8.5 percent of those who are eligible. The White House COVID-19 response coordinator, Ashish Jha, said at a press conference earlier this month that he expects booster uptake to increase in October as the temperatures drop and people start taking winter diseases more seriously. That doesn’t seem to be happening yet. America’s booster campaign is going so badly that by late September, only half of Americans had heard even “some” information about the bivalent boosters, according to a recent survey. The low numbers are especially unfortunate because the remaining 91.5 percent of booster-eligible people have already shown that they’re open to vaccines by getting at least their first two shots—if not already at least one booster.

    Now the bungled booster rollout could soon run headfirst into the winter wave. The virus is not yet surging in the United States—at least as far as we can tell—but as the weather cools down, cases have been on the rise in Western Europe, which has previously foreshadowed what happens in the U.S. At the same time, new Omicron offshoots such as BQ.1 and BQ.1.1 are gaining traction in the U.S., and others, including XBB, are creating problems in Singapore. Boosters are our best chance at protecting ourselves from getting swept up in whatever this virus throws at us next, but too few of us are getting them. What will happen if that doesn’t change?

    The whole reason for new shots is that though the protection conferred by the original vaccines is tremendous, it has waned over time and with new variants. The latest booster, which is called “bivalent” because it targets both the original SARS-CoV-2 virus and BA.5, is meant to kick-start the production of more neutralizing antibodies, which in turn should prevent new infection in the short term, Katelyn Jetelina, a public-health expert who writes the newsletter Your Local Epidemiologist, told me. The other two goals for the vaccine are still being studied: The hope is that it will also broaden protection by teaching the immune system to recognize other aspects of the virus, and that it will make protection longer-lasting.

    In theory, this souped-up booster would make a big difference heading into another wave. In September, a forecast presented by the Advisory Committee on Immunization Practices (ACIP), which advises the CDC, showed that if people get the bivalent booster at the same rate as they do the flu vaccine—optimistic, given that about 50 percent of people have gotten the flu vaccine in recent years—roughly 25 million infections, 1 million hospitalizations, and 100,000 deaths could be averted by the end of March 2023.

    But these numbers shouldn’t be taken as gospel, because protection across the population varies widely and modeling can’t account for all of the nuance that happens in real life. Gaming out exactly what our dreadful booster rates mean going forward is not a simple endeavor “given that the immune landscape is becoming more and more complex,” Jetelina told me. People received their first shots and boosters at different times, if they got them at all. And the same is true of infections over the past year, with the added wrinkle that those who fell sick all didn’t get the same type of Omicron. All of these factors play a role in how much America’s immunological guardrails will hold up in the coming months. “But it’s very clear that a high booster rate would certainly help this winter,” Jetelina said.

    At this point in the pandemic, getting COVID is far less daunting for healthy people than it was a year or two ago (although the prospect of developing long COVID still looms). The biggest concerns are hospitalizations and deaths, which make low booster uptake among vulnerable groups such as the elderly and immunocompromised especially worrying. That said, everyone aged 5 and up who has received their primary vaccine is encouraged to get the new boosters. It bears repeating that vaccination not only protects against severe illness and death but has the secondary effect of preventing transmission, thereby reducing the chances of infecting the vulnerable.

    What will happen next is hard to predict, Michael Osterholm, an epidemiologist at the University of Minnesota, told me, but now is a bad time for booster rates to be this low. Conditions are ripe for COVID’s spread. Protection is waning among the unboosted, immunity-dodging variants are emerging, and Americans just don’t seem to care about COVID anymore, Osterholm explained. The combination of these factors, he said, is “not a pretty picture.” By skipping boosters, people are missing out on the chance to offset these risks, though non-vaccine interventions such as masking and ventilation improvements can help, too.

    That’s not to say that the immunity conferred by the vaccination and the initial boosters is moot. Earlier doses still offer “pretty substantial protection,” Saad Omer, a Yale epidemiologist, told me. Not only are eligible Americans slacking on booster uptake, but lately vaccine uptake among the unvaccinated hasn’t risen much either. Before the new bivalent shots came around, less than half of eligible Americans had gotten a booster. “That means we are, as a population, much more vulnerable going into this fall,” James Lawler, an infectious-diseases expert at the University of Nebraska Medical Center, told me.

    If booster uptake—and vaccine uptake overall—remains low, expecting more illness, particularly among the vulnerable, would be reasonable, William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center, told me. Hospitalizations will rise more than they would otherwise, and with them the stress on the health-care system, which will also be grappling with the hundreds of thousands of people likely to be hospitalized for flu. While Omicron causes relatively minor symptoms, “it’s quite capable of producing severe disease,” Schaffner said. Since August, it has killed an average of 300 to 400 people each day.

    All of this assumes that we won’t get a completely new variant, of course. So far, the BA.5 subvariant targeted by the bivalent booster is still dominating cases around the world. Newer ones, such as XBB, BQ.1.1, and BQ.1, are steadily gaining traction, but they’re still offshoots of Omicron. “We’re still very hopeful that the booster will be effective,” Jetelina said. But the odds of what she called an “Omicron-like event,” in which a completely new SARS-CoV-2 lineage—one that warrants a new Greek letter—emerges out of left field, are about 20 to 30 percent, she estimated. Even in this case, the bivalent nature of the booster would come in handy, helping protect against a wider crop of potential variants. The effectiveness of our shots against a brand-new variant depends on its mutations, and how much they overlap with those we’ve already seen, so “we’ll see,” Omer said.

    Just as it isn’t too late to get boosted, there’s still time to improve uptake in advance of a wave. If you’re three to six months out from an infection or your last shot, the best thing you can do for your immune system right now is to get another dose, and do it soon. Though there’s no perfect and easy solution that can overcome widespread vaccine fatigue, that doesn’t mean trying isn’t worthwhile. “Right now, we don’t have a lot of people that feel the pandemic is that big of a problem,” and people are more likely to get vaccinated if they feel their health is challenged, Osterholm said.

    There’s also plenty of room to crank the volume on the messaging in general: Not long ago, the initial vaccine campaign involved blasting social media with celebrity endorsers such as Dolly Parton and Olivia Rodrigo. Where is that now? Lots of pharmacies are swimming in vaccines, but making getting boosted even easier and more convenient can go a long way too. “We need to catch them where they come,” said Omer, who thinks boosters should be offered at workplaces, in churches and community centers, and at specialty clinics such as dialysis centers where patients are vulnerable by default.

    After more than two years of covering and living through the pandemic, believe me: I get that people are over it. It’s easy not to care when the risks of COVID seem to be negligible. But while shedding masks is one thing, taking a blasé attitude toward boosters is another. Shots alone can’t solve all of our pandemic problems, but their unrivaled protective effects are fading. Without a re-up, when the winter wave reaches U.S. shores and more people start getting sick, the risks may no longer be so easy to ignore.

    Yasmin Tayag

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  • Flu Shots: Who Needs Them?

    Flu Shots: Who Needs Them?




    Who Needs the Flu Vaccine? Just About Everyone

































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  • Flu Shots: Who Needs Them?

    Flu Shots: Who Needs Them?




    Who Needs the Flu Vaccine? Just About Everyone

































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  • When’s the Perfect Time to Get a Flu Shot?

    When’s the Perfect Time to Get a Flu Shot?

    For about 60 years, health authorities in the United States have been championing a routine for at least some sector of the public: a yearly flu shot. That recommendation now applies to every American over the age of six months, and for many of us, flu vaccines have become a fixture of fall.

    The logic of that timeline seems solid enough. A shot in the autumn preps the body for each winter’s circulating viral strains. But years into researching flu immunity, experts have yet to reach a consensus on the optimal time to receive the vaccine—or even the number of injections that should be doled out.

    Each year, a new flu shot recipe debuts in the U.S. sometime around July or August, and according to the CDC the best time for most people to show up for an injection is about now: preferably no sooner than September, ideally no later than the end of October. Many health-care systems require their employees to get the shot in this time frame as well. But those who opt to follow the CDC current guidelines, as I recently did, then mention that fact in a forum frequented by a bunch of experts, as I also recently did, might rapidly hear that they’ve made a terrible, terrible choice.

    “There’s no way I would do what you did,” one virologist texted me. “It’s poor advice to get the flu vaccine now.” Florian Krammer, a virologist at Mount Sinai’s Icahn School of Medicine, echoed that sentiment in a tweet: “I think it is too early to get a flu shot.” When I prodded other experts to share their scheduling preferences, I found that some are September shooters, but others won’t juice up till December or later. One vaccinologist I spoke with goes totally avant-garde, and nabs multiple doses a year.

    Read: Should your flu and COVID shots go in different arms?

    There is definitely such a thing as getting a flu shot too early, as Helen Branswell has reported for Stat. After people get their vaccine, levels of antibodies rocket up, buoying protection against both infection and disease. But after only weeks, the number of those molecules begins to steadily tick downward, raising people’s risk of developing a symptomatic case of flu by about 6 to 18 percent, various studies have found. On average, people can expect that a good portion of their anti-flu antibodies “are meaningfully gone by about three or so months” after a shot, says Lauren Rodda, an immunologist at the University of Washington.

    That decline is why some researchers, Krammer among them, think that September and even October shots could be premature, especially if flu activity peaks well after winter begins. In about three-quarters of the flu seasons from 1982 to 2020, the virus didn’t hit its apex until January or later. Krammer, for one, told me that he usually waits until at least late November to dose up. Stanley Plotkin, a 90-year-old vaccinologist and vaccine consultant, has a different solution. People in his age group—over 65—don’t respond as well to vaccines in general, and seem to lose protection more rapidly. So for the past several years, Plotkin has doubled up on flu shots, getting one sometime before Halloween and another in January, to ensure he’s chock-full of antibodies throughout the entire risky, wintry stretch. “The higher the titers,” or antibody levels, Plotkin told me, “the better the efficacy, so I’m trying to take advantage of that.” (He made clear to me that he wasn’t “making recommendations for the rest of the world”—just “playing the odds” given his age.)

    Data on doubling up is quite sparse. But Ben Cowling, an epidemiologist and flu researcher at Hong Kong University, has been running a years-long study to figure out whether offering two vaccines a year, separated by roughly six months, could keep vulnerable people safe for longer. His target population is Hong Kongers, who often experience multiple annual flu peaks, one seeded by the Northern Hemisphere’s winter wave and another by the Southern Hemisphere’s. So far, “getting that second dose seems to give you additional protection,” Cowling told me, “and it seems like there’s no harm of getting vaccinated twice a year,” apart from the financial and logistical cost of a double rollout.

    Read: The strongest sign that Americans should worry about flu this winter

    In the U.S., though, flu season is usually synonymous with winter. And the closer together two shots are given, the more blunted the effects of the second injection might be: People who are already bustling with antibodies may obliterate a second shot’s contents before the vaccine has a chance to teach immune cells anything new. That might be why several studies that have looked at double-dosing flu shots within weeks of each other “showed no benefit” in older people and certain immunocompromised groups, Poland told me. (One exception? Organ–transplant recipients. Kids getting their very first flu shot are also supposed to get two of them, four weeks apart.)

    Even at the three-ish-month mark past vaccination, the body’s anti-flu defenses don’t reset to zero, Rodda told me. Shots shore up B cells and T cells, which can survive for many months or years in various anatomical nooks and crannies. Those arsenals are especially hefty in people who have banked a lifetime of exposures to flu viruses and vaccines, and they can guard people against severe disease, hospitalization, and death, even after an antibody surge has faded. A recent study found that vaccine protection against flu hospitalizations ebbed by less than 10 percent a month after people got their shot, though the rates among adults older than 65 were a smidge higher. Still other numbers barely noted any changes in post-vaccine safeguards against symptomatic flu cases of a range of severities, at least within the first few months. “I do think the best protection is within three months of vaccination,” Cowling told me. “But there’s still a good amount by six.”

    For some young, healthy adults, a decent number of flu antibodies may actually stick around for more than a year. “You can test my blood right now,” Rodda told me. “I haven’t gotten vaccinated just yet this year, and I have detectable titers.” Ali Ellebedy, an immunologist at Washington University in St. Louis, told me he has found that some people who have regularly received flu vaccines have almost no antibody bump when they get a fresh shot: Their blood is already hopping with the molecules. Preexisting immunity also seems to be a big reason that nasal-spray-based flu vaccines don’t work terribly well in adults, whose airways have hosted far more flu viruses than children’s.

    Getting a second flu shot in a single season is pretty unlikely to hurt. But Ellebedy compares it to taking out a second insurance policy on a car that’s rarely driven: likely of quite marginal benefit for most people. Plus, because it’s not a sanctioned flu-vaccine regimen, pharmacists might be reluctant to acquiesce, Poland pointed out. Double-dosing probably wouldn’t stand much of a chance as an official CDC recommendation, either. “We do a bad enough job,” Poland said, getting Americans to take even one dose a year.

    Read: America’s flu-shot problem is also its next COVID-shot problem

    That’s why the push to vaccinate in late summer and early fall is so essential for the single shot we currently have, says Huong McLean, a vaccine researcher at the Marshfield Clinic Research Institute in Wisconsin. “People get busy, and health systems are making sure that most people can get protected before the season starts,” she told me. Ellebedy, who’s usually a September vaccinator, told me he “doesn’t see the point of delaying vaccination for fear of having a lower antibody level in February.” Flu seasons are unpredictable, with some starting as early as October, and the viruses aren’t usually keen on giving their hosts a heads-up. That makes dillydallying a risk: Put the shot off till November or December, and “you might get infected in between,” Ellebedy said—or simply forget to make an appointment at all, especially as the holidays draw near.

    In the future, improvements to flu-shot tech could help cleave off some of the ambiguity. Higher doses of vaccine, which are given to older people, could rile up the immune system to a greater degree; the same could be true for more provocative vaccines, made with ingredients called adjuvants that trip more of the body’s defensive sensors. Injections such as those seem to “maintain higher antibody titers year-round,” says Sophie Valkenburg, an immunologist at Hong Kong University and the University of Melbourne—a trend that Ellebedy attributes to the body investing more resources in training its fighters against what it perceives to be a larger threat. Such a switch would likely come with a cost, though, McLean said: Higher doses and adjuvants “also mean more adverse events, more reactions to the vaccine.”

    For now, the only obvious choice, Rodda told me, is to “definitely get vaccinated this year.” After the past two flu seasons, one essentially absent and one super light, and with flu-vaccination rates still lackluster, Americans are more likely than not in immunity deficit. Flu-vaccination rates have also ticked downward since the coronavirus pandemic began, which means there may be an argument for erring on the early side this season, if only to ensure that people reinforce their defenses against severe disease, Rodda said. Plus, Australia’s recent flu season, often a bellwether for ours, arrived ahead of schedule.

    Even so, people who vaccinate too early could end up sicker in late winter—in the same way that people who vaccinate too late could end up sicker now. Plotkin told me that staying apprised of the epidemiology helps: “If I heard influenza outbreaks were starting to occur now, I would go and get my first dose.” But timing remains a gamble, subject to the virus’s whims. Flu is ornery and unpredictable, and often unwilling to be forecasted at all.

    Katherine J. Wu

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