This year's flu season hits children hard

Flu activity has declined slightly in recent weeks, but the test positivity rate for the virus remains elevated at 24.5% for the week ending Feb. 22. COVID-19 and respiratory syncytial virus (RSV) have remained largely stable with 4.3% and 7.1% test positivity rates, respectively. 

As of Feb. 22, 41 jurisdictions reported either "high" or "very high" levels of influenza-like illnesses (ILI). Outpatient visits for ILI also continue to be elevated above the national baseline (3%) at 5.8%, although there was a slight decrease from the previous week. 

Flu hospitalization rates continue to be higher than both COVID-19 and RSV. As of Feb. 22, the flu hospitalization rate was 6.3 per 100,000 people, compared to 1.5 per 100,000 for COVID-19 and 1.8 per 100,000 for RSV.

"Death is obviously the most severe outcome, but there is a huge spectrum between well and not well," Patel said. "The flu can take a previously healthy kid and land them on a ventilator."

So far this flu season, CDC estimates that there have been at least 37 million illnesses, 480,000 hospitalizations, and 21,000 deaths. There have also been 98 pediatric flu deaths, including 12 reported the week ending Feb. 22.

Next year's flu vaccine

Over the last few weeks, federal health agencies have either postponed or canceled meetings of their vaccine advisory committees, leading to concerns from public health experts during a highly severe flu season.

Last month, HHS officials indefinitely postponed a public meeting of CDC's Advisory Committee on Immunization Practice (ACIP), which was originally scheduled to take place between Feb. 26 and Feb. 28. According to a draft agenda of the meeting, ACIP members were expected to discuss the effectiveness of influenza vaccines, new recommendations for influenza and RSV vaccines, and more.

Separately, FDA last week abruptly canceled a March 13 meeting of its Vaccines and Related Biological Products Advisory Committee (VRBPAC). According to Paul Offit, a VRBPAC member and director of the Vaccine Education Center at the Children's Hospital of Philadelphia, FDA did not give VRBPAC members a reason for the cancellation or rescheduling information.

"The cancellation of the FDA's Vaccines and Related Biological Products Advisory Committee meeting is alarming," said Susan Kressly, president of the American Academy of Pediatrics. "We are in the middle of one of the worst flu seasons in years, and children are being hospitalized at concerning rates."

Some health experts have also expressed concerns about how the canceled meeting will impact next season's flu vaccine supply since drugmakers cannot make the vaccines until FDA selects the strains that will be targeted. VRBPAC typically makes recommendations on which flu strains to target before FDA makes its final decision.

"If the strain selection happens much later than now, it's going to be really, really tight, but the manufacturers will scramble and can make it happen," said Litjen Tan, co-chair of the National Adult and Influenza Immunization Summit. "If the delay is any longer than late March, it's going to put manufacturers into a huge bind."

In a statement, HHS spokesperson Andrew Nixon said that FDA will "make public its recommendations to manufacturers in time for updated vaccines to be available for the 2025-2026 influenza statement. Drugmakers, including Sanofi and GSK, have also indicated that they are still working with FDA and are preparing for the next flu season.

Sanofi has "already begun production for the 2025-2026 flu season in the Northern Hemisphere and will be ready to support final strain selections in time for the season," the company said.