The U.S. last year hit a grim milestone: the most pediatric flu deaths since before the pandemic.

Even though a record number of kids died from the flu last year, the percentage of children getting flu shots continues to plummet.

The Centers for Disease Control and Prevention reported Wednesday that as of Nov. 30, just over a third of U.S. kids — 37% — had gotten flu shots, down from 43% at the same time last year.

The downward trend worries pediatricians who are starting to see an uptick in flu cases.

“I always have a little bit of dread when flu season is around the corner,” said Dr. Kristina Bryant, a pediatric infectious disease doctor at Norton Children’s in Louisville, Kentucky, “because children experience illness and suffering during flu season, and much of that can be prevented through vaccination.”

Just over half of kids, 55%, got the flu shot during the 2023-24 season, the lowest rate in 12 years, said Alicia Budd, head of the CDC’s domestic influenza surveillance team.

“Flu coverage had been slowly increasing” before Covid hit, Budd said. “Flu vaccination levels have not rebounded to pre-pandemic levels.”

This year’s flu shot covers the two main strains of the virus circulating so far, H1N1 and H3N2.

Budd said any strain of the flu can be dangerous for kids. “We are not seeing anything yet that would indicate that this season would be any different,” she said.

A preliminary report released in October suggested the flu shots’ effectiveness at keeping kids ages 5 and younger out of the hospital may be on the lower end, at just 39%. Last year’s shot was estimated to be up to 61% effective at preventing hospitalization in kids.

Dr. Michelle Taylor, a pediatrician who is the health officer of the Shelby County Health Department in Memphis, Tennessee, said the flu vaccine is safe and worthwhile, even if it’s not perfect.

“Even if you’re exposed and you are positive for flu, that shot gives the best chance of having a much easier course of illness than if you had not been vaccinated at all,” Taylor said.

‘The worst I’ve ever felt’

Kaitlyn Covert, a freshman at the University of Florida, hadn’t made time to get her flu shot before she got sick in October. Hurricane Milton was churning off the Florida coast, and Covert and her friends were planning parties because classes were canceled.

That was until a throbbing headache set in, said Covert, 18. She was too weak to reach for an ibuprofen on her bedside table.

“Breathing hurt. Coughing hurt,” she said. “It was the worst I’ve ever felt in my entire life.” A trip to the campus urgent care center confirmed she had the flu.

Covert ultimately recovered, but worry among her family members had set in. Two decades earlier, Kaitlyn’s 4-year-old cousin had died from the flu.

“I was in panic mode,” said her mother, Amy. “Does lightning strike twice?” 

Flu season was particularly deadly for kids last year, when 205 children died — a record number since before the pandemic.

But the true tally of flu deaths among kids could be much higher, because not all children who die are tested for flu. The CDC estimated in a Nov. 22 post on its website that 724 pediatric flu deaths might have occurred last year.

Fewer flu shots and an unusually long flu season are two likely factors.

“Some seasons, we see a really sharp peak and then it goes away quickly. Other seasons are more long and drawn-out,” Budd said. “Last year was more drawn-out, so unfortunately, there was more opportunity for children to get infected.”