Potential impact of changes in influenza vaccination coverage and effectiveness on pediatric influenza burden in the United States, 2022/23-2024/25
- 1Centers for Disease Control and Prevention
Abstract
Background and ObjectivesInfluenza vaccination has a strong safety record and is effective in reducing pediatric influenza-associated morbidity and mortality. However, pediatric vaccination coverage (VC) has declined since the 2019/20 influenza season in the United States. We estimated the impact of increased vaccine protection (through increased VC and/or vaccine effectiveness [VE]) on pediatric influenza-associated burden during the 2022/23-2024/25 seasons.
MethodsWe used a compartmental model and laboratory-confirmed influenza-associated hospitalization, VC, and VE data among children 6 months-17 years to estimate influenza burden from 2022/23-2024/25 (the baseline scenario) and the impact of vaccination. We simulated scenarios that (1) increased VC by five percentage points; (2) increased VE by five percentage points; (3) increased VC and VE by five percentage points; and (4) increased VC to levels achieved in 2019/20 (the season with the highest pediatric VC to date). We estimated the difference in hospitalizations and deaths between each scenario and the baseline scenario.
ResultsAmong children 6 months-17 years, an estimated 120,000 influenza-associated hospitalizations and 1,650 deaths occurred across all seasons at baseline. Increasing VC to 2019/20 levels had the greatest estimated impact, reducing hospitalizations by 8,670 (7.2%) and deaths by 130 (7.9%). Increasing both VC and VE by five percentage points reduced hospitalizations by 6.6% and deaths by 6.7%, whereas increasing VC or VE by five percentage points reduced hospitalizations by 3.1% and deaths by 3.2%.
ConclusionsIncreasing pediatric influenza vaccination coverage back to 2019/20 levels was estimated to significantly reduce pediatric influenza-associated morbidity and mortality.
Whats known on this subjectPediatric influenza vaccination coverage has declined in the United States since the 2019/20 influenza season despite its effectiveness and strong safety record. The impact of this decline on influenza-associated morbidity and mortality has not been quantified.
What this study addsWe estimated pediatric influenza-associated outcomes in the 2022/23-2024/25 influenza seasons under different scenarios that increased vaccination coverage and/or effectiveness. We estimated the greatest reductions in influenza-associated hospitalizations and deaths (7.2% and 7.9%, respectively) if coverage remained at 2019/20 levels.
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BibTeX
@misc{morris2026potential,
title = {{Potential impact of changes in influenza vaccination coverage and effectiveness on pediatric influenza burden in the United States, 2022/23-2024/25}},
author = {S. E. Morris and S. M. Mathis and J. R. Chung and J. DeCuir and S. M. Olson and S. Ellington and A. O'Halloran and D. Ujamaa and C. H. Bozio and A. Jain and A. Srivastav and P.-j. Lu and L. A. Grohskopf and C. Reed and A. D. Iuliano and M. Biggerstaff},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.25.26363797},
url = {https://www.medrxiv.org/content/10.64898/2026.09.25.26363797v1},
note = {CC0},
}
RIS
TY - UNPB
TI - Potential impact of changes in influenza vaccination coverage and effectiveness on pediatric influenza burden in the United States, 2022/23-2024/25
AU - S. E. Morris
AU - S. M. Mathis
AU - J. R. Chung
AU - J. DeCuir
AU - S. M. Olson
AU - S. Ellington
AU - A. O'Halloran
AU - D. Ujamaa
AU - C. H. Bozio
AU - A. Jain
AU - A. Srivastav
AU - P.-j. Lu
AU - L. A. Grohskopf
AU - C. Reed
AU - A. D. Iuliano
AU - M. Biggerstaff
PY - 2026
DA - 2026/09/25
PB - medRxiv
DO - 10.64898/2026.09.25.26363797
UR - https://www.medrxiv.org/content/10.64898/2026.09.25.26363797v1
AB - Background and ObjectivesInfluenza vaccination has a strong safety record and is effective in reducing pediatric influenza-associated morbidity and mortality. However, pediatric vaccination coverage (VC) has declined since the 2019/20 influenza season in the United States. We estimated the impact of increased vaccine protection (through increased VC and/or vaccine effectiveness [VE]) on pediatric influenza-associated burden during the 2022/23-2024/25 seasons. MethodsWe used a compartmental model and laboratory-confirmed influenza-associated hospitalization, VC, and VE data among children 6 months-17 years to estimate influenza burden from 2022/23-2024/25 (the baseline scenario) and the impact of vaccination. We simulated scenarios that (1) increased VC by five percentage points; (2) increased VE by five percentage points; (3) increased VC and VE by five percentage points; and (4) increased VC to levels achieved in 2019/20 (the season with the highest pediatric VC to date). We estimated the difference in hospitalizations and deaths between each scenario and the baseline scenario. ResultsAmong children 6 months-17 years, an estimated 120,000 influenza-associated hospitalizations and 1,650 deaths occurred across all seasons at baseline. Increasing VC to 2019/20 levels had the greatest estimated impact, reducing hospitalizations by 8,670 (7.2%) and deaths by 130 (7.9%). Increasing both VC and VE by five percentage points reduced hospitalizations by 6.6% and deaths by 6.7%, whereas increasing VC or VE by five percentage points reduced hospitalizations by 3.1% and deaths by 3.2%. ConclusionsIncreasing pediatric influenza vaccination coverage back to 2019/20 levels was estimated to significantly reduce pediatric influenza-associated morbidity and mortality. Whats known on this subjectPediatric influenza vaccination coverage has declined in the United States since the 2019/20 influenza season despite its effectiveness and strong safety record. The impact of this decline on influenza-associated morbidity and mortality has not been quantified. What this study addsWe estimated pediatric influenza-associated outcomes in the 2022/23-2024/25 influenza seasons under different scenarios that increased vaccination coverage and/or effectiveness. We estimated the greatest reductions in influenza-associated hospitalizations and deaths (7.2% and 7.9%, respectively) if coverage remained at 2019/20 levels.
ER -