New research projects increasing the US pediatric influenza vaccination rate to the Healthy People 2030 goal of 70% would avert more than 2.2 million outpatient visits, 30,494 hospitalizations, and 123 pediatric deaths during a high-incidence season, easing strain on health systems. 

The findings, presented at the recent Pediatric Academic Societies (PAS) 2026 Meeting in Boston, highlight the potential consequences of the continued slide in pediatric flu vaccine uptake, such as increased healthcare visits and hospitalizations, said the authors, from flu vaccine maker CSL Seqirus.

Low vaccine uptake can speed flu spread among all ages

The modeling study was designed to estimate the effects of low flu vaccine coverage in children aged 6 months to 17 years. 

It projected that if the current pediatric flu vaccination rate of about 50% continued during a season of high flu incidence more than 4.4 million outpatient visits, 59,000 hospitalizations, and 234 deaths could be expected, with occupancy of 14,000 hospital beds and 2,000 intensive care unit (ICU) beds at the seasonal peak. 

During a season with low influenza circulation, a 50% pediatric flu vaccination rate would translate to roughly 1.5 million outpatient visits, 18,000 hospitalizations, and 70 deaths, with occupancy of 3,000 hospital beds and 457 ICU beds used at the peak of activity. 

A nationwide survey of 380 US internal medicine (IM) resident physicians suggests that those interested in specializing in infectious diseases (ID) are more likely to cite early exposure to the specialty, mentorship from an ID physician, and interests in public or global health, while uninterested respondents report concerns about compensation, training length, and limited procedural opportunities.

The study authors, led by a team from Baylor Scott & White Medical Center, said the findings, published today in Clinical Infectious Diseases, should prompt resident programs to use recruitment strategies targeting these barriers, as well as increase early engagement and mentorship opportunities.

“A 2020 study examining the distribution of ID specialists found that 89.4% of counties have below-average or no ID physicians present,” they noted. “This deficit is expected to worsen as recent ID fellowship match data have demonstrated a years-long decline in the percentage of ID positions filled.”

More early opportunities needed to explore public, global health

The team fielded the 19-question survey to IM resident physicians across the country, with 41 of 637 programs (6.4%), including 380 residents, responding.

Interest in ID was significantly associated with an interest in public and global health and service-oriented careers. Early ID exposures such as mentorship from an ID physician, an ID rotation during medical school, and shadowing an ID physician outside of required rotations were tied to increased interest. 

Since exposure to ID typically occurs at medical schools, academic medical centers, and hospitals in the United States, it is essential to integrate opportunities to explore public health, global health, and community engagement at these levels.

During residency, early exposure to ID in the first and second years, outpatient ID electives, and ID-related research were linked to increased interest. Common reasons given for lack of ID interest were low compensation, the need for more training, long work hours, and limited opportunities to perform procedures.

“Since exposure to ID typically occurs at medical schools, academic medical centers, and hospitals in the United States, it is essential to integrate opportunities to explore public health, global health, and community engagement at these levels,” the authors wrote.

New reporting from Politico says the US Department of Health and Human Services (HHS) under Secretary Robert F. Kennedy Jr. is holding up $600 million in funds that Congress has appropriated for the use of vaccines in low-income countries. The move is intended to put pressure on Gavi, the Vaccine Alliance, the report said.

Gavi said it has not received any funding for this year or last year, and the missing funds make up 15% of its operating budget. 

HHS told Politico, “Gavi has refused to provide the United States with the specific data, studies, or detailed accounting of how U.S. funds are used.” The funds will expire on September 30 if they are not used.

Kennedy wants thimerosal-containing vaccines gone

Gavi provides 20 vaccines, including measles, mumps, and rubella vaccine, to 30 low-income countries. The main issue likely is Gavi’s use of thimerosal-containing vaccines, which are commonly used in countries lacking adequate refrigeration for vaccines. 

In January, the Trump administration linked phasing out thimerosal-containing vaccines to future US funding. Last June, the Kennedy-reconstituted Advisory Committee on Immunization Practices recommended that US patients avoid flu shots that contain thimerosal. And just last week, during congressional testimony, Kennedy incongruously raised the Gavi-thimerosal link when discussing environmental mercury exposure, which involves a serious, neurotoxic form of mercury, not the much safer thimerosal found in some vaccine.

Last week, Kennedy also told a Senate committee that Gavi uses a diphtheria, tetanus and pertussis vaccine that had been discontinued in the United States because it was causing brain injury. That shot hasn’t been used in the United States since 1997, but the World Health Organization said there is no evidence the vaccine is linked to brain damage. 

Gavi said the vaccine is given to children in low-income countries because it offers long-lasting protection, and “is safe and effective and estimated to have saved 40 million lives in the past 50 years.”