Christine Wear’s voice wavers as she talks about the approaching flu season.
“Anxieties are high,” she said. “We’re trying to navigate what life should look like without being in a bubble.”
Her 4-year-old son, Beckett, is still recovering from the flu he caught back in January. Within a week, he became extremely lethargic—unable to move his head or arms, eat, or speak.
Wear, 40, of River Forest, Illinois, recognized the signs immediately. It was the second time Beckett had developed an inflammatory brain disease triggered by the flu: acute necrotizing encephalopathy, or ANE.
This recovery has been slower than the first. “It has taken longer for his brain to recover,” Wear said.
When Beckett was first diagnosed in September 2022, he hadn’t yet received his yearly flu shot. By the time he developed ANE the second time, he had been vaccinated. Experts note that flu shots may be less effective in children who’ve already experienced flu-related brain inflammation.
Cases of pediatric ANE and other flu-related encephalopathies are increasing. During the 2024–25 flu season, 109 children were diagnosed with this rare complication, according to new data from the Centers for Disease Control and Prevention.
Of the children with influenza-associated encephalopathy whose vaccination status was known, 84% hadn’t been vaccinated.
This comes amid 280 pediatric flu deaths last year—the deadliest flu season for children outside of the 2009–10 H1N1 pandemic—and declining rates of childhood flu vaccination.
“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.”
Though ANE is rare, usually just a handful of cases each year, doctors have anecdotally observed an increase in children experiencing severe brain inflammation after flu infections this year.
“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 and co-author of the CDC study.
Dangerous complications from the flu
All 109 children in the study were diagnosed with influenza-associated encephalopathy (IAE), which occurs when the influenza virus attacks the nervous system. Symptoms can range from confusion and difficulty walking to hallucinations, abnormal movements, and seizures.
Wilson-Murphy identifies at least seven forms of IAE. ANE, Beckett’s illness, represented about a third of the cases in the report.
Among children with influenza-associated encephalopathy:
- 74% were admitted to the intensive care unit
- 54% required a ventilator
- 55% had previously been 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
While seasonal flu shots may not prevent every infection as reliably as vaccines like MMR, doctors emphasize their critical role in reducing 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 up to 78% effective in preventing hospitalizations among children and teens. About 90% of the 280 children who died last flu season had not 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.
Early data from the Southern Hemisphere’s flu season show the vaccine has cut flu-related hospitalizations by roughly half. Yet fewer children are being vaccinated each year—49.2% last year, down from 62.4% in the 2019–20 season, according to the CDC.
O’Leary attributes the decline to several factors, including vaccine hesitancy and access to care issues. “Many practices face staffing challenges and may not be able to host large flu clinics after hours or on weekends,” he said.
The CDC recommends annual flu shots for everyone 6 months and older. For children like Beckett, who are especially vulnerable, it’s even more crucial that everyone around them stays protected, Christine Wear said.
