Kids are being hit hard by the flu this year, with hospitalizations and emergency department visits spiking, some Cleveland-area pediatricians say.

“Some years, the various strains don’t affect kids as much. Sometimes it affects kids more, and we’re definitely seeing that,” said Dr. Amy Edwards, an associate professor of pediatrics at Case Western Reserve University. 

Edwards said she’s consulting on an unusually large number of cases of kids with the flu or complications of it, such as pneumonia.  

The state’s director of health, Dr. Bruce Vanderhoff, affirmed during a statewide press briefing Wednesday that children under 11 and people over age 65 are the most at risk of getting very sick and hospitalized. At the end of December, the state reported its first pediatric flu death of the season, a 16-year-old girl. 

Vanderhoff said Edwards’ observation is consistent with national data on who is feeling the effects of this year’s flu. 

Other pediatricians say it’s still too early to tell whether the flu’s impact on children is outsized compared to previous years. Dr. Camille Seballa is the director of pediatric infectious diseases at Cleveland Clinic Children’s. He’s seeing a significant rise in children who show up at the emergency department and who are hospitalized with influenza and complications of it. But he says he can’t yet determine what that means. 

Ninety people in Cuyahoga County were hospitalized for the flu between Dec. 21 and 27. Most hospitalizations were amongst the county’s oldest residents, said Jana Rush, the director of epidemiology for the county’s board of health. In Cleveland, the median age for flu hospitalization that week was 64, though patients ranged in age from 3 weeks to 94 years.

In general, children are less likely than adults to be hospitalized with the flu, Edwards said. 

Lots of children do appear to be showing up at emergency rooms with flu-like illnesses, though. Nearly 80% of the people who went to the emergency department for an upper respiratory illness between Dec. 21 and 27 were children under the age of 19, according to data from the City of Cleveland.

“We are seeing a ton of kids with flu coming in, both to urgent cares and EDs,” Edwards said. Often, they can return home after getting an IV and Tylenol and don’t require hospitalization, she said. 

Before the holidays, school absences in Cuyahoga County rose above historic norms, potentially due to the flu virus, said Rush. The board has not investigated any specific flu outbreaks at schools so far this season, she said. 

Is it too late to get a flu shot?

One challenge kids and adults are facing this flu season? The flu shot given out this year is not particularly effective at combating the primary flu variant circulating this year, called Subclade K, Seballa said. That means even those who received a vaccine might have to deal with the flu. 

Seballa, Edwards and Vanderhoff are still recommending the flu shot, though. Even though it’s not perfectly matched to this year’s main flu virus, it still protects against severe illness, Vanderhoff said. 

And, it covers other strains of the flu, which are also circulating in the community, Seballa said. 

Vaccination rates for flu dropped among Ohio children this year, from about 40% to about 38%. Rates went up for adults, from 41.3% to about 47%.  

The federal government is changing its guidance around flu vaccines for children. The U.S. Centers for Disease Control used to universally recommend seasonal flu shots for everyone, meaning anyone could walk into a pharmacy to get a shot, Edwards said. But the federal government said on Monday that flu shots – and half a dozen others – should now be given to children after a “shared decision-making” process with a doctor. The agency still recommends the shot for high-risk children. 

Federal officials said the change would increase public trust by recommending only the most important vaccinations for kids. But Edwards said the move will add an extra barrier – having to see a doctor – to getting a flu shot. 

“Why are we making it complicated? Why are we – like why are we introducing unnecessary confusion?” Edwards said.