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Influenza vaccine effectiveness against influenza-associated hospitalizations and emergency department or urgent care encounters among children and adults - United States, 2024-25 season

DeCuir, J.; Reeves, E. L.; Weber, Z. A.; Yang, D.-H.; Irving, S. A.; Tartof, S. Y.; Klein, N. P.; Grannis, S. J.; Ong, T. C.; Ball, S. W.; DeSilva, M. B.; Dascomb, K.; Naleway, A. L.; Koppolu, P.; Salas, S. B.; Sy, L. S.; Lewin, B.; Contreras, R.; Zerbo, O.; Hansen, J. R.; Block, L.; Jacobson, K. B.; Dixon, B. E.; Rogerson, C.; Duszynski, T.; Fadel, W. F.; Barron, M. A.; Mayer, D.; Chavez, C.; Yates, A.; Kirshner, L.; McEvoy, C. E.; Akinsete, O. O.; Essien, I. J.; Sheffield, T.; Bride, D.; Arndorfer, J.; Van Otterloo, J.; Natarajan, K.; Ray, C. S.; Payne, A. B.; Adams, K.; Flannery, B.; Garg,

2026-04-24 public and global health
10.64898/2026.04.22.26350853 medRxiv
Show abstract

Background: The 2024-25 influenza season was the most severe in the United States (US) since 2017-18, with co-circulation of both influenza A virus subtypes (H1N1 and H3N2). Influenza vaccine effectiveness (VE) has varied by season, setting, and patient characteristics. Methods: Using electronic healthcare encounter data from eight US states, we evaluated influenza vaccine effectiveness (VE) against influenza-associated hospitalizations and emergency department or urgent care (ED/UC) encounters from October 2024-April 2025 among children aged 6 months-17 years and adults aged 18+ years. Using a test-negative, case-control design, we compared the odds of influenza vaccination between acute respiratory illness (ARI) encounters with a positive (cases) versus negative (controls) test for influenza by molecular assay, adjusting for confounders. Results: Analyses included 108,618 encounters (5,764 hospitalizations and 102,854 ED/UC encounters) among children and 309,483 encounters (76,072 hospitalizations and 233,411 ED/UC encounters) among adults. Among children across care settings, 17.0% (6,097/35,765) of cases versus 29.4% (21,449/72,853) of controls were vaccinated. Among adults, 28.2% (21,832/77,477) of cases versus 44.2% (102,560/232,006) of controls were vaccinated. VE was 51% (95% confidence interval [95% CI]: 41-60%) against influenza-associated hospitalizations and 54% (95% CI: 52-55%) against influenza-associated ED/UC encounters among children. VE was 43% (95% CI: 41-46%) against influenza-associated hospitalizations and 49% (95% CI: 47-50%) against influenza-associated ED/UC encounters among adults. Conclusions: Influenza vaccination provided protection against influenza-associated hospitalizations and ED/UC encounters among children and adults in the US during the severe 2024-25 influenza season. These findings support influenza vaccination as an important tool to reduce influenza-associated disease.

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