Respiratory Infections in Children Under 5 Tripled: Post-Pandemic Immunity Gap Drives Record Hospitalizations in
Quick Facts
Why Are Respiratory Infections So Severe in Children Right Now?
CDC data documents significantly elevated respiratory virus hospitalizations in children under 5 compared to pre-pandemic averages. RSV accounts for the largest share of admissions, followed by influenza A and human metapneumovirus. Pediatric ICU utilization has been strained in many hospitals.
Serological surveys find that many young children lack detectable antibodies to RSV and influenza compared to historical rates, reflecting the expanded susceptible cohort that produces more severe clinical presentations.
When Will Pediatric Respiratory Hospitalizations Return to Normal Levels?
CDC modeling projects declining rates over the coming seasons. The ACIP has recommended nirsevimab (Beyfortus) for all infants under 8 months entering their first RSV season, plus high-risk children up to 19 months, with increasing uptake rates.
Frequently Asked Questions
Yes. Multiple peer-reviewed studies in The Lancet, JAMA Pediatrics, and Nature Immunology have documented larger respiratory virus outbreaks following periods of reduced pathogen circulation.
Ensure recommended vaccinations are up to date including annual influenza vaccination for children 6 months and older. Ask pediatricians about nirsevimab for RSV protection in infants. Practice good hand hygiene and seek medical attention promptly for breathing difficulties.
The effect is most pronounced in children under 5. Children aged 5–12 show moderately elevated rates, while adult rates have largely returned to baseline.
References
- Baker RE et al. The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections. Proc Natl Acad Sci USA. 2020;117(48):30547-30553.
- Cohen R et al. Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic. Infectious Diseases Now. 2021;51(5):418-423.
- CDC. RSV Surveillance & Research. Centers for Disease Control and Prevention. 2025.