By Tim Henderson, Stateline.org
Americans are facing the highest death toll from influenza since 2018, just as more people become vulnerable because of growing vaccine skepticism taking hold in statehouses and the Trump administration.
Flu-related deaths hit a seven-year high in January and February, the two months that usually account for the height of flu season, according to a Stateline analysis of preliminary federal statistics. There were about 9,800 deaths across the country, up from 5,000 in the same period last year and the most since 2018, when there were about 10,800.
Despite that, the U.S. Department of Health and Human Services has canceled or postponed meetings to prepare for next fall’s flu vaccine, when experts talk about what influenza strains they expect they’ll be battling.
The cancellations raised protests from medical professionals and state and federal officials. U.S. Sen. Kirsten Gillibrand, a New York Democrat, said in a statement that her state is having its worst flu season in at least 15 years, with more deaths from flu and other causes as the state’s health care system struggles under the strain of flu patients.
Some experts say putting off vaccine planning will only feed false narratives that discourage lifesaving vaccinations.
“These delays not only weaken pandemic preparedness but also undermine public confidence in vaccination efforts,” said Dr. Akram Khan, an Oregon pulmonologist and associate professor at Oregon Health & Science University who has studied attitudes toward vaccines.
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U.S. Health and Human Services Secretary Robert Kennedy Jr. has expressed doubt about the need for vaccines, including flu vaccines, despite evidence that they reduce deaths and hospitalizations.
Deaths fluctuate naturally from year to year depending on the severity of current flu strains and the effectiveness of that year’s vaccines. But some see a hesitancy to use any vaccine, fed by misinformation and political mistrust of government, already taking a toll on lives.
“It’s been a bad winter for viral respiratory infections, not just in the United States but across the Northern Hemisphere,” said Mark Doherty, a vaccine scholar and former manager for GlaxoSmithKline Biologicals, a vaccine manufacturer.
“The U.S. does appear to be hit a bit harder, and it’s possible lower vaccination coverage is contributing to that,” Doherty said.
Flu vaccine distribution in the United States has been declining in recent years, and as of the first week of 2025 was down 16% from 2022, according to federal statistics.
The flu was a factor in 9,800 deaths in January and February, according to the analysis, using provisional data collected by states and compiled by the federal Centers for Disease Control and Prevention.
The highest death rates were in Oklahoma, Minnesota, Pennsylvania, South Dakota and Kentucky, all at about four deaths per 100,000 population so far this year. Some counties in Florida, New Jersey and Pennsylvania, as well as Oklahoma and Kentucky, were even higher — at about six deaths per 100,000.
The highest rates have been among older people. Statistics show the deaths hit white people and American Indians especially hard.
Tragedies are happening across the country to people of all ages and races, however. A 43-year-old Indiana father died after a brief bout of the flu, according to family members. After two 10-year-olds died in Prince George’s County, Maryland, area schools drew crowds to vaccine clinics.
Doug Sides, a pastor at Yulee Baptist Church in northern Florida, has held funerals for three congregation members who died from flu — all within one month, all of them over 70 years old. That compares with only one victim of COVID-19 from his congregation during the pandemic, he said.
“Flu death is a reality,” Sides told Stateline on a phone call from a Jacksonville hospital, where he was visiting another 84-year-old congregation member who was rescued from her home with severe pneumonia from an unknown cause.
“I encourage my church members to keep their hands clean, use hand sanitizer and to stay home if they’re feeling sick,” he said. He said he hasn’t personally gotten a flu vaccine recently because he gets conflicting advice about it — some doctors tell him to avoid them because he and some family members have cancer, while another “rides me all the time about getting a flu shot.”
“We’re all getting conflicting advice. We’re living in strange-o times,” he said. (The American Cancer Society says vaccination for people with cancer may or may not be recommended depending on individual circumstances.)
Many states are relaxing vaccine requirements as public skepticism rises. But many are taking action to warn residents and reassure them that vaccinations are safe and can help prevent deaths, despite misinformation to the contrary.
Burlington County, New Jersey, has had the highest flu-associated death rate of any county this year, according to the analysis, with 31 deaths among fewer than 500,000 people. The county held 30 free vaccine clinics from September to January, then extended them into February because of the severity of the flu season, said Dave Levinsky, a spokesperson for the county health department.
In Oklahoma, death rates are highest in the eastern part of the state where the Cherokee Nation is centered. A state publicity campaign stresses that flu shots are safe, effective and free at many community health centers. However, vaccination rates in the state are low compared with other states as of December, according to federal statistics: Only about 16% of Oklahoma residents had gotten flu vaccinations by then. Rates were even lower in Louisiana (just under 16%), Mississippi (12%) and Texas (10%).
States with the highest flu vaccination rates by December were Maine (37%), Connecticut and Vermont (33%), and Wisconsin and Minnesota (31%). But even those were down since 2022.
People have become less likely to get vaccinated in recent years, a phenomenon researchers call “vaccine hesitancy.”
A report published last year in the medical journal Cureus found three-quarters of patients in a rural New York state community refused flu vaccine with comments such as “I do not trust vaccines” or “I do not believe in vaccines.” The most common reasons cited were that earlier vaccinations made them feel sick, that they got the flu anyway, or that they thought they shouldn’t need a new shot every year. (Doctors recommend flu vaccinations annually and note that even vaccinated patients who get the flu usually face less severe forms.)
And in a paper published in February in the journal Vaccine, researchers found that people refuse flu vaccinations for many of the same reasons they refused COVID-19 shots: a feeling of “social vulnerability” that leads to distrust of government and medical guidance. One hopeful sign, the report noted, is that vaccine recommendations from trusted health care professionals can turn around such attitudes.
“Unfortunately, vaccine hesitancy is deeply entangled with misinformation, political rhetoric and public distrust,” said Khan, the Oregon pulmonologist and the study’s author. “Scientific data alone may not be enough to shift public perceptions, as many vaccine decisions are driven by gut feelings and external influences rather than evidence.”
©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.
