The NewsWorthy: Special Edition – Flu Season & Conflicting Vaccine Recommendations

Date: January 31, 2026
Host: Erica Mandy
Guest: Dr. Celine Gounder (Editor at Large for Public Health at KFF Health News, physician, infectious disease specialist, epidemiologist at NYU and Bellevue Hospital)

Episode Overview

This special episode of The NewsWorthy covers the unusually severe 2025-26 flu season, discusses the split between the American Academy of Pediatrics (AAP) and the CDC on vaccine recommendations, and explores what these changes mean for families. Dr. Celine Gounder provides clarity on flu symptoms, treatments, contagiousness, and updated guidance, with special attention to child health and vaccine coverage.

Key Discussion Points and Insights

1. Current Flu Season Status

• Peak of the Season:
  • Dr. Gounder says the U.S. has likely reached the peak in terms of flu cases, though hospitalizations and deaths may lag behind ([01:31]).

    “We have largely peaked in terms of flu cases...should be seeing a decline in the coming weeks.” — Dr. Gounder ([01:31])

• Early Peak Due to H3N2:
  • This year’s dominant flu strain, H3N2, is known for early, severe peaks due to lower population immunity ([01:58]).

    “It rips through the population more quickly, peaks more quickly, but also tends to cause a worse flu season than average.” — Dr. Gounder ([01:58])

• ER Visits in Kids Rising:
  • Despite declining overall cases, ER visits for school-aged children remain high ([01:24], [02:18]).

2. Symptoms, Severity, and When to Seek Emergency Care

• Common Symptoms: Fever, nausea, vomiting, chills, diarrhea. Hard to distinguish from COVID, RSV, or norovirus without testing ([02:23]).
• Warning Signs:
  • Extremely high fever (104°F+), difficulty breathing, inability to keep down food or water, or signs of dehydration (dark urine, less urination) warrant an ER visit ([03:00]).

    “If you’re talking like 104, you know, that alone is going to be a reason you want to go to the ER, especially in a child.” — Dr. Gounder ([03:00])

3. Treatments & Timing

• Antivirals (Tamiflu, Xofluza):
  • Most effective if started within 1–2 days of symptom onset ([03:37]).

    “By the time you land in the hospital, it’s really too late.” — Dr. Gounder ([04:08])

4. Contagiousness and Return to Public Life

• When Flu is Most Contagious:
  • Peak contagiousness is 3–4 days after symptom onset. Children may spread the flu before symptoms and longer than adults ([04:18]).
• Return to School/Work:
  • Wait at least 3-4 days after symptoms begin, ideally one week, and once symptoms are improving ([05:04]).

5. Vaccine Uptake and Effectiveness

• Decline in Flu Shot Rates:
  • Fewer people are getting vaccinated, fueling a more severe season ([05:25]).

    “We’ve seen a big drop in people getting flu shots this year...that has contributed to this being one of the worst flu years in recent years.” — Dr. Gounder ([05:25])

• Vaccine’s Value:
  • Protection remains “reasonable” against severe disease, hospitalization, and death, even with possible strain mismatch ([05:51]).
• Most Severe Cases in the Unvaccinated:
  • Unvaccinated people are most frequently hospitalized; if a vaccinated person is hospitalized, it’s usually someone older or immunocompromised ([06:30]).

6. CDC vs. AAP: Conflicting Vaccine Recommendations

• CDC’s Rationale for Updating Recommendations:
  • The CDC now recommends flu vaccination as a “shared clinical decision,” partly driven by an ideology of limiting government mandates, rather than new science ([07:00]).

    “This was not based on science per se...This is really about more of an ideology of not wanting to tell people what they should do.” — Dr. Gounder ([07:00])

• International Comparisons:
  • Dr. Gounder calls comparisons to Denmark misleading, as U.S. health system inequities are more similar to countries that retain universal vaccine recommendations ([07:31]).

7. The Risks of Downplaying Flu

• Analogy:
  • Comparing vaccination to wearing a seatbelt—most of the time you don’t need it, until you do ([08:14]).

    “It’s just the flu until it’s not...that’s why we do these things, whether it’s wearing a seatbelt...or getting your vaccines up to date, because you can’t be sure that it’s always going to be that way.” — Dr. Gounder ([08:14])

• Pregnancy and Risk:
  • “Pregnancy is one period where your immune system is suppressed...there are other things that can happen where you don’t know.” ([08:14])

8. COVID-19 Vaccine Attitudes & Severity

• Perception vs. Reality:
  • COVID-19 is medically still causing more severe disease than flu, even though the public urgency has decreased ([09:35]).

    “Covid is still causing more severe disease hospitalization and death than flu, although it’s coming down closer to the same level as flu.” — Dr. Gounder ([09:35])

• Most Affected Groups:
  • Elderly (65+, especially 80+), children under five are at highest risk for severe COVID, flu, and RSV ([10:18]).

9. Insurance & Vaccine Coverage

• Coverage for Kids:
  • Even with CDC changes, insurance will continue (at least through 2026) to cover vaccines recommended by the AAP, but families should check with their provider ([14:07]).

10. Measles Risks and Declining Vaccination

• Rising Threats:
  • Concerningly low MMR (measles, mumps, rubella) vaccination rates in some areas (even lower than 60%), and outbreaks are expected to rise ([14:48]).
  • Lags in public health data updates impede outbreak responses ([15:36]).

    “There are huge proportions of the country that are under vaccinated for MMR right now...We can expect more outbreaks over the coming months.” — Dr. Gounder ([14:48])

11. Public Health Frustration

• Vaccines as Essential Prevention:
  • Dr. Gounder expresses frustration over growing vaccine hesitancy, stressing vaccines are among the most cost-effective health interventions ([16:13]).

    “If you care about preventing illness, if you care about saving lives...vaccines are a no brainer.” — Dr. Gounder ([16:13])

Notable Quotes & Memorable Moments

• “We’ve seen a big drop in people getting flu shots this year...that has contributed to this being one of the worst flu years in recent years.” ([05:25])
• “It’s just the flu until it’s not...that’s why we do these things, whether it’s wearing a seatbelt...or getting your vaccines up to date...” ([08:14])
• “By the time you land in the hospital, it’s really too late.” ([04:08])
• “The fact that you have two sets of guidelines is really unprecedented.” ([12:39])

Important Segment Timestamps

• Flu peak, H3N2 strain: [01:31]–[01:58]
• Symptoms & ER warning signs: [02:23]–[03:34]
• Treatments & antiviral timing: [03:37]–[04:08]
• Return to school/work (contagiousness): [04:18]–[05:04]
• Vaccine uptake and effectiveness: [05:25]–[06:30]
• CDC vs. AAP vaccine recommendation split: [06:48]–[08:06]; [12:29]–[13:58]
• Public health analogies and vaccine value: [08:14]
• COVID vaccination and severity: [09:35]–[10:18]
• Insurance/coverage status: [14:07]
• Measles outbreak risk: [14:48]–[16:02]
• Expert frustration with vaccine hesitancy: [16:13]

Actionable Takeaways & Advice for Listeners

• Know the warning signs that mean you should seek urgent medical care for flu, especially in children ([03:00]).
• Start antivirals early if flu is suspected; don’t wait ([03:37]).
• Time your return to work/school carefully—wait until after peak contagiousness and symptom improvement ([05:04]).
• Ask your pediatrician which vaccine schedule they are following and why, especially with the new AAP-CDC divergence ([12:39]).
• Check with your insurance provider to confirm vaccine coverage ([14:07]).
• Vaccination protects you and the community—rates are dropping, leading to increased outbreaks for flu and measles ([14:48], [05:25]).

This episode offers clear, candid advice for parents and the broader public navigating a tough flu season—and confusion over vaccine guidance—in a way that’s both authoritative and accessible. Dr. Gounder emphasizes the ongoing value of vaccines as a proven, essential tool for individual and public health.