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Influenza Vaccine Effectiveness Among Children With and Without Underlying Conditions
Haya Hayek1, Emma K Noble2,3, Laura S Stewart1
1Vanderbilt University Medical Center, Nashville, Tennessee.
Pediatrics
|January 8, 2026
Summary
Influenza vaccination is effective for children, including those with underlying health conditions. This study found vaccine effectiveness (VE) was 43% for children with underlying conditions and 53% for those without.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health
Background:
- Annual influenza vaccination is recommended for children aged 6 months and older in the US.
- Children with underlying conditions face higher risks of severe influenza complications.
- Vaccine effectiveness (VE) in this high-risk group is less understood.
Purpose of the Study:
- To assess influenza vaccine effectiveness (VE) against laboratory-confirmed influenza.
- To compare VE in children with and without underlying conditions.
- To evaluate VE in children presenting to emergency departments or hospitalized.
Main Methods:
- Enrolled 15,875 US children (6 months–17 years) across 5 influenza seasons (2015-2020).
- Confirmed influenza via molecular testing; verified vaccination status through registries/clinicians.
- Abstracted underlying conditions from medical records or parental reports.
Main Results:
- Overall VE was 43% (95% CI: 35%-50%) for children with underlying conditions and 53% (95% CI: 47%-59%) for those without.
- Significant effect modification by underlying conditions (P=.04).
- Lowest VE observed in children with respiratory conditions (31%, 95% CI: 19%-42%).
Conclusions:
- Influenza vaccination offers protection to both children with and without underlying conditions.
- Improving vaccination coverage is crucial for reducing severe influenza complications.
- Early influenza treatment is essential, especially for high-risk pediatric populations.
