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COVID-19 and Influenza Deaths in Australian Children 2018-2023: A National Case Analysis

Jocelynne E McRae1, Yuanfei Anny Huang1, Mehyar Khair Baik1

  • 1National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia.

Journal of the Pediatric Infectious Diseases Society
|November 5, 2025
PubMed

Insights

COVID-19 and influenza have similar attributable mortality rates in Australian children. Accurate data is crucial for public health strategies and vaccination policies to prevent severe respiratory virus infections.

Area of Science:

  • Pediatric infectious diseases
  • Epidemiology
  • Public health

Background:

  • Understanding the severity of COVID-19 and influenza in children is vital for effective public health strategies, including vaccination.
  • This study focuses on comparing mortality rates attributable to these viruses in the Australian pediatric population.

Purpose of the Study:

  • To estimate and compare the mortality rates attributed to COVID-19 (caused by SARS-CoV-2) and influenza in children under 18 years old in Australia.
  • To inform public health policies by accurately assessing the burden of these respiratory viruses.

Main Methods:

  • A case series approach was used for children hospitalized with laboratory-confirmed SARS-CoV-2 or influenza who died.
  • Data were collected from January 2020 to September 2023 for COVID-19 and seasonally from 2018 to September 2023 for influenza from eight sentinel children's hospitals.
  • An expert panel assessed the causal attribution of each virus to death, and mortality rates were calculated using national surveillance data.

Main Results:

  • Attributable in-hospital mortality proportions were 58% for COVID-19 and 79% for influenza.
  • Nearly half (47%) of attributable deaths occurred in children without pre-existing comorbidities.
  • Adjusted average annualized mortality rates per million population were 0.78 for COVID-19 and 1.06 for influenza.

Conclusions:

  • Crude mortality estimates for COVID-19 and influenza in children may overestimate severity by including non-attributable deaths.
  • Accurate, age-specific attributable mortality rates and comorbidity data are essential for developing informed vaccination policies and public health interventions.
  • This research highlights the importance of precise data for managing high-burden respiratory viruses in pediatric populations.
Abstract

Keywords:
COVID-19childinfantinfluenzamortality

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