A Centennial of Death: The Great Pandemic Influenza of 1918

The recommendation is for all children, with special emphasis on the importance of protecting children, and those with respiratory diseases (including asthma) or other health problems. But the recommendation is also one of the most vulnerable to influenza and has a special obligation. Pregnant women who are also at higher risk of serious illness and should look at the vaccine as a priority.

"When children go and get the vaccine," said Michael Worobey, head of the department of ecology and evolutionary biology at the University of Arizona, who works on the evolution of the 1918 influenza virus. "The beautiful thing is that even if it is the person who is vaccinated, that has an impact."

Influenza is a miserable disease even when it is not deadly. "Even though we know some people are at higher risk," said Dr. Lisa Grohskopf, a medical officer in the epidemiology and prevention branch of the influenza division at the C.D.C. She said that while they are fluent, they are fluent in fluency, "a substantial proportion of the children who die every year do not have underlying conditions."

There were 183 pediatric deaths in 2017-18, she said, which was higher than in the previous few seasons. Already this year, at least one child has been reported to have died of flu.

There's no good way to predict that we're looking for a particular bad season. Last year's season was classified as severe, Dr. Grohskopf said, and it went on for a long time. The C.D.C. Reporting and monitoring for the new season has just gotten underway.

The influenza vaccine has been reformulated every year, to protect against the viruses. However, immunization means a degree of protection against really severe illness. And in addition to protecting against the strains of influenza A, H1N1 and H3N2, the influenza B, Dr. Worobey said, which gets less publicity, but actually causes more deaths than H1N1.

Dr. Grohskopf said that immunization coverage is better than younger children, and then starts to drop. Last season, 67.8 percent of children from 6 months to 4 years old were immunized, but only 47.4 percent of 13- to 17-year-olds. That's a lot of children left exposed.