Christine Wear’s voice trembles talking about the upcoming flu season.

“Anxieties are high,” she said. “We’re trying to navigate what life should look like without being in a bubble.”

Beckett, Wear’s 4-year-old son, is still in recovery from the flu he contracted back in January. Within a week of catching the virus, he became extremely fatigued. He was unable to move his head or arms and was incapable of eating or speaking.

Wear, 40, residing in River Forest, Illinois, identified the issue immediately. Beckett was experiencing his second episode of an inflammatory brain condition induced by the flu: acute necrotizing encephalopathy, or ANE.

This time, bouncing back to his energetic self has been slow. “It has taken longer for his brain to recover,” Wear said.

The incidence of pediatric ANE and other flu-related brain diseases is increasing. During the 2024-25 flu season, there were 109 cases of the rare condition in children, according to recent data from the Centers for Disease Control and Prevention.

This finding emerged as the country recorded 280 pediatric flu fatalities last year, the most lethal year aside from the 2009-10 H1N1 pandemic, alongside a decline in flu vaccination rates among children.

“We can’t always anticipate which children will suffer the most severe flu complications, which is why we advocate the vaccine for all,” stated Dr. Buddy Creech, a pediatric infectious disease expert at Vanderbilt University Medical Center in Nashville, Tennessee. “It’s incorrect to think that only children with pre-existing conditions face flu complications.”

ANE is rare — just a handful of cases each year — and has never been formally tracked.

This year, however, doctors anecdotally noted an uptick in kids severely affected with brain inflammation after having the flu.

“We don’t have exact numbers to confirm an increase, but from my experience as a physician caring for these patients, I certainly noticed a rise,” commented Dr. Molly Wilson-Murphy, a pediatric neurologist at Boston Children’s Hospital and co-author of the CDC’s recent study.

Dangerous complications from the flu

The 109 children tallied in the research were all diagnosed with influenza-associated encephalopathy, or IAE. It occurs when the influenza virus attacks the child’s nervous system. Kids can have a spectrum of symptoms: confusion, difficulty walking, hallucinations, abnormal movements and seizures.

Wilson-Murphy suspects there are at least seven forms of IAE.

ANE, Beckett’s illness, is one of them. ANE accounted for about a third of the overall IAE cases in the report.

Of the children with influenza-associated encephalopathy:

• 74% were admitted to the intensive care unit
• 54% were put on a ventilator
• 55% were previously healthy
• 19% died

“Flu is dangerous for children, period,” said Dr. Keith Van Haren, a co-author of the study and a pediatric neurologist at Stanford Medicine in Palo Alto, California. “That is not a mischaracterization.”

Childhood flu vaccine rates are falling

Seasonal flu shots are notoriously subpar when it comes to preventing flu infections, compared with more robust vaccines like the measles-mumps-rubella (MMR) vaccine.

But doctors say the shot’s benefit lies in its ability to reduce the chance the infection will lead to severe complications and death.

“Our goal as parents and doctors is to keep kids healthy and to help protect kids who are at risk from getting sicker,” Van Haren said. “Vaccination against the flu is the purest, best, simplest way to do that.”

Last year, the flu shot was found to be up to 78% effective in keeping kids and teens with the flu out of the hospital.

According to the new report, 84% of kids with influenza-associated encephalopathy whose vaccination status was known weren’t vaccinated.

And 90% of the 280 children who died last flu season hadn’t received their annual flu shot.

“The best way to protect yourself and your family from influenza is for everyone to get vaccinated,” said Dr. Sean O’Leary, an infectious diseases expert with the American Academy of Pediatrics.

Pediatricians generally recommend kids get their flu shots before the end of October. A peek at how the shot has been working so far in the Southern Hemisphere’s flu season shows the vaccine is cutting down on flu-related hospitalizations by half.

But the percentage of kids getting their flu shots has been falling in recent years.

According to the CDC, fewer than half of kids (49.2%) had their flu shot last year, down from 62.4% in the 2019-20 flu season.

O’Leary said that reasons for the decline are complex. Increasing vaccine hesitancy is just one factor.

“A lot of families are experiencing access to care issues,” he said. “And a lot of practices are experiencing significant staffing issues. They might not be able to have large flu clinics after hours or on Saturdays.”

With rare exceptions, the CDC recommends everyone 6 months and older get a flu shot every year.