Influenza vaccine effectiveness against influenza-associated hospitalizations and emergency department or urgent care encounters among children and adults — United States, 2024–25 season
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. Brief Summary: During the 2024-25 influenza season, influenza vaccination provided protection against influenza-associated hospitalizations (43-51%) and emergency department or urgent care encounters (49-54%) among children and adults in the United States.
Authors
- Allison L. Naleway (ORCID: https://orcid.org/0000-0001-5747-4643)
- Brendan Flannery (ORCID: https://orcid.org/0000-0001-5041-308X)
- Inih Essien (ORCID: https://orcid.org/0000-0003-0775-8255)
- Ousseny Zerbo (ORCID: https://orcid.org/0000-0002-8380-6215)
- Lindsey Kirshner
- Caitlin Ray (ORCID: https://orcid.org/0000-0001-6740-936X)
- Lina S. Sy (ORCID: https://orcid.org/0000-0003-2762-9266)
- Michelle A. Barron (ORCID: https://orcid.org/0000-0002-8217-7410)
- Sara Y. Tartof (ORCID: https://orcid.org/0000-0003-2336-8476)
- Thomas J. Duszynski (ORCID: https://orcid.org/0000-0003-1860-2774)
- Nicola P. Klein (ORCID: https://orcid.org/0000-0003-1777-4814)
- Malini B. DeSilva (ORCID: https://orcid.org/0000-0003-3705-1672)
- John Hansen (ORCID: https://orcid.org/0000-0001-7891-2673)
- Zachary A. Weber (ORCID: https://orcid.org/0000-0001-6896-5050)
- Shaun J. Grannis (ORCID: https://orcid.org/0000-0002-8093-6639)
- Colin Rogerson (ORCID: https://orcid.org/0000-0001-5251-2399)
- Stephanie A. Irving (ORCID: https://orcid.org/0000-0001-7437-6797)
- Julie Arndorfer
- Omobosola Akinsete
- Daniel Bride (ORCID: https://orcid.org/0000-0002-7950-1267)
- Jennifer DeCuir
- Karthik V. Natarajan (ORCID: https://orcid.org/0000-0002-9066-9431)
- Kristin Dascomb (ORCID: https://orcid.org/0000-0002-7422-060X)
- Richard Contreras
- Tamara Sheffield
- Sarah Ball (ORCID: https://orcid.org/0000-0002-3015-0793)
- Charlene McEvoy (ORCID: https://orcid.org/0000-0002-2813-9106)
- St Salas
- Duck‐Hye Yang
- Josh Van Otterloo
- Adam Yates
- David Mayer
- Toan Ong
- Brian E. Dixon
- Emily L. Reeves
- Karen B. Jacobson
- Lawrence Block
- Shikha Garg
- Catia Chavez
- Padma Koppolu
- Amanda B. Payne
- Bruno Lewin
- Katherine Adams
- William F. Fadel
Institutions
- Intermountain Healthcare (US)
- Centers for Disease Control and Prevention (US)
- Regenstrief Institute (US)
- Westat (United States) (US)
- NewYork–Presbyterian Hospital (US)
- Kaiser Permanente (US)
- National Center for Immunization and Respiratory Diseases (US)
- Columbia University Irving Medical Center (US)
- Kaiser Permanente Center for Health Research (US)
- Richard M. Fairbanks Foundation (US)
- University of Colorado Anschutz Medical Campus (US)
- HealthPartners (US)
- Indiana University – Purdue University Indianapolis (US)
Publication Details
- Journal
- medRxiv
- Published
- 2026-04-24
- DOI
- https://doi.org/10.64898/2026.04.22.26350853
- Primary Topic
- Influenza Virus Research Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Kaiser Permanente