Christine Wear’s voice trembles talking about the upcoming flu season.
“Anxieties are high,” she said. “We’re trying to navigate what life should look like without being in a bubble.”
Wear’s son, 4-year-old Beckett, is still recovering from the flu he got way back in January. Within a week of becoming infected, he became extremely lethargic. He couldn’t move his head or his arms. He couldn’t eat or talk.
Wear, 40, of River Forest, Illinois, knew what the problem was. It was the second time Beckett had developed an inflammatory brain disease caused by the flu: acute necrotizing encephalopathy, or ANE.
This time, bouncing back to his energetic self has been slow. “It has taken longer for his brain to recover,” Wear said.
Cases of pediatric ANE and other flu-related encephalopathies are on the rise. During the 2024-25 flu season, 109 children were diagnosed with the rare complication, according to new data from the Centers for Disease Control and Prevention.
The finding comes as the nation logged 280 pediatric flu deaths last year, the deadliest ever aside from the 2009-10 H1N1 pandemic, as well as falling rates of children vaccinated against influenza.
“We don’t always know how to predict which kids are going to have the most severe forms of flu, which is why we recommend the vaccine for everyone,” said Dr. Buddy Creech, a pediatric infectious disease physician at Vanderbilt University Medical Center in Nashville, Tennessee. “It’s a misnomer to think that only sickly kids get complications from the flu.”
ANE is rare — just a handful of cases each year — and has never been formally tracked.
This year, however, doctors anecdotally noted an uptick in kids severely affected with brain inflammation after having the flu.
“We don’t know in real numbers if this is an increase, but I will tell you, being on the ground, being a physician who cares for these patients, I was certainly struck that this was an increase,” said Dr. Molly Wilson-Murphy, a pediatric neurologist at Boston Children’s Hospital. She is also an author of the new study published by the CDC.
Dangerous complications from the flu
The 109 children tallied in the research were all diagnosed with influenza-associated encephalopathy, or IAE. It occurs when the influenza virus attacks the child’s nervous system. Kids can have a spectrum of symptoms: confusion, difficulty walking, hallucinations, abnormal movements and seizures.
Wilson-Murphy suspects there are at least seven forms of IAE.
ANE, Beckett’s illness, is one of them. ANE accounted for about a third of the overall IAE cases in the report.
Of the children with influenza-associated encephalopathy:
- 74% were admitted to the intensive care unit
- 54% were put on a ventilator
- 55% were previously healthy
- 19% died
“Flu is dangerous for children, period,” said Dr. Keith Van Haren, a co-author of the study and a pediatric neurologist at Stanford Medicine in Palo Alto, California. “That is not a mischaracterization.”
Childhood flu vaccine rates are falling
Seasonal flu shots are notoriously subpar when it comes to preventing flu infections, compared with more robust vaccines like the measles-mumps-rubella (MMR) vaccine.
But doctors say the shot’s benefit lies in its ability to reduce the chance the infection will lead to severe complications and death.
“Our goal as parents and doctors is to keep kids healthy and to help protect kids who are at risk from getting sicker,” Van Haren said. “Vaccination against the flu is the purest, best, simplest way to do that.”
Last year, the flu shot was found to be up to 78% effective in keeping kids and teens with the flu out of the hospital.
According to the new report, 84% of kids with influenza-associated encephalopathy whose vaccination status was known weren’t vaccinated.
And 90% of the 280 children who died last flu season hadn’t received their annual flu shot.
“The best way to protect yourself and your family from influenza is for everyone to get vaccinated,” said Dr. Sean O’Leary, an infectious diseases expert with the American Academy of Pediatrics.
Pediatricians generally recommend kids get their flu shots before the end of October. A peek at how the shot has been working so far in the Southern Hemisphere’s flu season shows the vaccine is cutting down on flu-related hospitalizations by half.
But the percentage of kids getting their flu shots has been falling in recent years.
According to the CDC, fewer than half of kids (49.2%) had their flu shot last year, down from 62.4% in the 2019-20 flu season.
O’Leary said that reasons for the decline are complex. Increasing vaccine hesitancy is just one factor.
“A lot of families are experiencing access to care issues,” he said. “And a lot of practices are experiencing significant staffing issues. They might not be able to have large flu clinics after hours or on Saturdays.”
With rare exceptions, the CDC recommends everyone 6 months and older get a flu shot every year.
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