Flu Deaths in U.S. Children, 2024–25: The Most in a Non-Pandemic Season

Flu deaths among U.S. children under 18 have been reported to CDC nationally since 2004, after a rise in such deaths drew attention. Since then, the most deaths in a single season — 288 — came during the 2009–10 H1N1 pandemic. The previous high for an ordinary season was 210, in 2023–24. In 2020–21, when COVID-19 precautions nearly stopped flu from circulating, just one child died of flu, and the number has risen every season since.

The 2024–25 season set a new non-pandemic record.

The toll

From September 29, 2024, to September 13, 2025, 280 flu-associated deaths in children were reported — 3.8 per million children — and the count may still rise as reports arrive.

• The median age at death was 7; 61% of the children were younger than 9.
• The death rate was highest among babies under 6 months (11.1 per million), who are too young to be vaccinated.
• It was higher among girls (4.5 per million) than boys (3.1).
• Black children had the highest rate (5.8 per million) and accounted for 23% of deaths. White children accounted for the most deaths (42%) but had the second-lowest rate (3.1), after Asian children (2.8).
• Deaths peaked at 28 a week in early to mid-February 2025.

Flu-associated deaths in children by week of death and virus type, 2024–25. Image from CDC’s page.

The virus

Influenza A caused 240 (86%) of the deaths and influenza B 38 (14%). Where the A subtype was known, 56% were H1N1 and 43% H3N2, closely matching what laboratories saw in young people generally that season. Both subtypes circulating in near-equal measure may help explain why the season was so active; the reasons are not clear.

Who the children were

• 56% of children with known medical histories had at least one underlying condition — most often a neurologic condition (63% of them), and among those, about two-thirds had developmental delay.
• Of the vaccine-eligible children whose status was known, 89% were not fully vaccinated — up from about 80% in earlier seasons. Children with medical conditions were only slightly more likely to be vaccinated (86% not fully vaccinated) than those without (95%).

How the illness progressed

• Complications were documented in 88% of children with data. The most common were shock or sepsis (108 children), pneumonia (82), acute respiratory distress syndrome (60), seizures (53), and encephalopathy or encephalitis (40). A bacterial infection was found in 42 of the 102 children tested, most often Staphylococcus aureus, Streptococcus pneumoniae or group A Streptococcus.
• Only 40% received flu antiviral medicine, almost all of them oseltamivir.
• Half never reached a hospital bed: 22% died outside a hospital and 27% in an emergency department, while 51% died after admission.
• Children who died outside a hospital or in an emergency department died fast — a median of 3 and 2 days after falling ill, against 7 days for those in hospital — were less likely to have an underlying condition, and very few had antivirals (23% and 11%, against 62% in hospital).

A severe season overall

The 2024–25 season was the first high-severity flu season since 2017–18, with severity high in every age group. Preliminary estimates put it at at least 43 million illnesses, 560,000 hospitalizations and 38,000 deaths.

What parents and clinicians can do

• Vaccinate. CDC recommends a flu vaccine every year for everyone 6 months and older without a contraindication, ideally by the end of October.
• Know the warning signs. Parents, caregivers and clinicians should watch for signs of complications when a child has a respiratory illness and seek care immediately.

Limitations

• Child flu deaths are likely undercounted, because flu may not be diagnosed, deaths may be attributed to other causes, or cases may go unreported.
• Details such as medical conditions and vaccination may be misclassified, especially for very young children or those who died quickly.
• Some information was missing, more often for children who died outside a hospital.

Sources

Based on Reinhart K, Huang S, Kniss K, Reed C, Budd A, "Influenza-Associated Pediatric Deaths — United States, 2024–25 Influenza Season," Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention; a work of the United States government in the public domain.