Special Edition: Flu Season & Conflicting Vaccine Recommendations

Summary

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)

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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.

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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])

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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])

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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]

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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]).

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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.

Transcript

[A]

Today is Saturday, January 31st. This week, the American Academy of Pediatrics released its updated vaccine schedule for kids and for the first time in decades, it does not fully match the CDC's recommendations. All of this is happening as this year's flu season is one of the worst in recent years. So today we're getting clarity about the latest strain of flu and conflicting vaccine recommendations from one of the country's leading public health experts. My guest is Dr. Celine Gounder. She's editor at large for public health at KFF Health News and a physician, infectious disease specialist and epidemiologist at NYU and Bellevue Hospital. She helps us break down what this split between the AAP and the CDC actually means for families where this flu season stands right now and what flu symptoms, treatments and timing really matter. We hope this helps you feel more prepared and make more informed decisions for yourself and your family. Welcome to the NEWSWORTHY Special EDITION Saturday when we sit down with a different expert or celebrity every Saturday to talk about something in the news. Forget to tune in every Monday through Friday for our regular episodes where we provide all the day's news in less than 15 minutes. I'm Erica Mandy. It's now time for today's special edition Saturday. Dr. Celine Gounder, thank you so much for joining us here on THE newsworthy.

[B]

It's great to be here.

[C]

So from what I'm reading, at least, flu activity is starting to decline nationwide, even while ER visits for school aged.

[A]

Kids at least is still increasing. So can you give us an update on where the flu season stands right.

[C]

Now and how serious is it?

[B]

We have largely peaked in terms of flu cases. There is a lag after people get flu before you'll see a peak in hospitalizations and deaths because it takes time to get sicker and unfortunately in some cases die. But we have hit sort of that peak of people getting infected and should be seeing a decline in the coming weeks.

[A]

Is this an earlier peak of flu cases than we typically see?

[C]

I thought it was usually kind of February.

[B]

Yeah, this is earlier. And it's because the predominant type of flu that's been circulating, H3N2, is known for causing earlier peaks. It has to do with having less population immunity. So it rips through the population more quickly, peaks more quickly, but also tends to cause a worse flu season than average. Yeah.

[C]

So what types of symptoms are you seeing? And when you say worse, what are you referring to?

[B]

Well, worse in terms of severity, worse in terms of hospitalization rates, worse in terms of death rates. The symptoms of the flu overlap a Lot with symptoms of COVID or RSV or even norovirus. So it's fever, nausea, vomiting, chills, sometimes diarrhea. It's hard to know if you have the flu or something else without getting a test.

[C]

What do you think parents, and really for adults too, should know about when it goes from the flu? That, you know, you can be at home and just kind of get through the symptoms versus this turns into an emergency or it becomes so severe that you need to potentially go to the er?

[B]

Yeah. So some of the signs or symptoms that you want to be looking for, an extremely high fever. So 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. Difficulty breathing, shortness of breath. In a baby, that might be the flaring of the nose, abdominal breathing, heavy breathing. And then if somebody's not able to keep food and water down. Another sign of dehydration, other than just not drinking enough, would be peeing less or really dark urine. Those would be things that would be concerning.

[C]

What do you think people need to know about using Tamiflu?

[B]

Yeah, so there's two antivirals we most commonly use these days, Tamiflu, and then there's also Xofluza. The key thing here is to start these medications very early. And so they really need to be started within a day or two of exposure and developing symptoms. The problem is most people wait until more than three days out. You really need to, as soon as you suspect you might have the flu, get a test, and then get a prescription. By the time you land in the hospital, it's really too late.

[C]

Also, when it comes to timing, what do you think people need to know about when the flu is most contagious? When is it okay to go back.

[A]

Into the world for adults?

[C]

Maybe grocery shopping or back to school for kids?

[B]

So kids can spread influenza for longer than adults. Kids can be shedding the virus for children several days actually before they develop symptoms, and they can spread it for longer, even beyond a week. Adults may be contagious a day or so before they develop symptoms and contagious for five days, maybe a week after they've developed symptoms. And in general, three to four days after symptoms begin is when you have the peak of contagiousness, when you have the most viral shedding.

[C]

So what does that mean in real life for parents? I mean, obviously there's nothing you can do if they don't have symptoms and you don't know they have the. And might be shedding it. But once symptoms do hit, let's say.

[A]

Their fever has been gone for more.

[C]

Than 24 hours, how do you make that decision about whether to send them back to school or let them play with other kids?

[B]

There's not a specific rule on this, but again, going by when somebody's most contagious, waiting at least three, four days after symptoms begin and start to improve, and then ideally, probably a week after those symptoms begin and there's been improvement.

[A]

Anything else standing out to you or surprising you about this year's flu season that you want to add?

[B]

We've seen a big drop in people getting flu shots this year and unfortunately, that has contributed to this being one of the worst flu years in recent years. I think a lot of this is related to a backlash to all vaccines.

[C]

So what is the impact typically or that you're seeing this year on symptoms in vaccinated versus not vaccinated people, people? And how is the vaccine lining up with this year's strain?

[B]

When we see an H3N2 flu, we do worry about vaccine mismatch. Although some of the early data that's come out looking at this is actually pretty good, it still is providing reasonable protection against severe disease, hospitalization and death. And I think it's important to remind people that for most vaccines, that's the goal. It is a huge bonus if you're able to prevent infection.

[A]

And so, in other words, the main.

[C]

Point of getting vaccinated is to have less severe symptoms and potentially avoid going to the hospital. Are you seeing this year that most.

[A]

Of the, ER cases are involving people who are unvaccinated for the flu?

[B]

Oh, sure. Usually it's unvaccinated people. If it is somebody who's been vaccinated, it's usually somebody much older who has underlying medical conditions. Maybe they're immunocompromised, but most of the people we're seeing hospitalized for flu are not vaccinated.

[A]

The CDC recently removed the seasonal flu.

[C]

Vaccine from the list of vaccine it broadly recommends to children.

[A]

Can you give people an idea of what the CDC's reasoning was for that? I want to first be clear about their reasoning.

[C]

And then what's your response to that?

[B]

Yeah, so this was not based on science per se. There's been no change in data regarding safety or vaccine effectiveness that applies to the CDC's changes and recommendations on flu vaccines as well as other vaccines. There's been no change. This is really about more of an ideology of not wanting to tell people what they should do and Telling people, just talk to your doctor and make a decision with them.

[A]

And this idea that international norms are different than the U.S. can you speak.

[B]

To that a little bit? There's been this comparison to Denmark. And if you actually look at Denmark, one, Denmark is actually an outlier among European countries. And two, if you look at the United States in terms of our access to healthcare, healthcare coverage, inequities in income and so on, the United States States is actually much more similar to countries like Chile or Saudi Arabia or Brazil, where these vaccines are still recommended universally in all of those countries. And so it's really a false comparison to be saying, oh, why don't we do what Denmark does? We're not Denmark.

[C]

What do you want people to know who think, well, this is just the flu. People get sick, but they usually recover. And it's very common and happens every year.

[B]

It's just the flu until it's not. And it's a little bit like when you drive, when you're riding in a car, most of the time you drive around and you don't get into an accident. And does it matter that you wore your seatbelt or not? Maybe not, because you didn't get into an accident until you do. And so that's why we do these things, whether it's wearing a seatbelt or a bike helmet or getting your vaccines up to date, because you can't be sure that it's always going to be that way. I'll give you a brief anecdote. I had a woman who was hospitalized who was pregnant. In this case, it was Covid, but sort of similar story. Who said, every time I had Covid before, I was fine. Well, this time she was pregnant. She got Covid. She ended up in the icu. And pregnancy is one period where your immune system is suppressed to allow your body to tolerate the foreign tissue of the pregnancy of the baby. But there are other things that can happen where you don't know. Sometimes it's just a question of stress, where your immune system's not as strong as it might be, maybe lack of sleep, any number of things. And so the idea here is to give you another layer of protection to reduce the risk that those things can happen.

[A]

And I guess since you brought up.

[C]

Covid, even talking to my son's doctors.

[A]

It feels less urgent than flu, less needed than flu.

[C]

What do you think people need to know about the COVID vaccine at this point?

[B]

I don't think that's true. Medically speaking, Covid is still causing more severe disease hospitalization and death than flu, although it's coming down closer to the same level as flu. I think that's really more a question of COVID fatigue and Covid having been the most controversial of the vaccines because it was newer and because people were showing their resistance to public health recommendations by refusing the vaccine. Flu vaccines have been in use for much longer. People are more familiar with them and so I think it's a easier sell than Covid vaccines.

[A]

Is there a certain age that we're.

[C]

Seeing right now with COVID that is having the most severe disease?

[A]

Is it still older folks?

[B]

Yeah. In General, people over 65, in particular over 80, have the most severe cases of flu, Covid and RSV. But you also have severe disease in middle aged adults as well as the youngest of kids. Children under the age of five after the elderly have the highest rates of ER visits and hospitalizations and sometimes even death.

[A]

Still ahead, the key questions parents may want to ask their pediatricians right now, including which vaccine schedule they're following and why. We also get into what's still covered by insurance and share updates on Covid and measles as this shift plays out. But first, a quick break for our sponsor. There are a lot of decisions to make as a parent, but one that's been super simple for me two years ago and is still true today in 2026 is giving my son Haya's children's vitamins. While other products seem to prioritize candy like appeal, Haya looked at what modern kids are actually eating or not eating and formulated around those specific nutritional gaps, working alongside pediatricians and nutrition scientists. And still my son loves taking his Haya vitamins and probiotics. He loves the taste, the colors and just the routine of it. And I love that. Haya earned Clean Label Project's highest purity award certification and puts every batch of product through third party testing for heavy metals and contaminants in GMP compliant labs. Oh, and if getting your kids to eat vegetables feels like an impossible daily battle, Haya's New Kids Daily Greens plus Superfoods is a total game changer. It's basically chocolate milk stuffed with veggies. It's a greens powder that's packed with over 55 whole food sourced ingredients. Just mix one scoop with milk or any non dairy beverage and watch them actually enjoy something that's secretly fueling their growing bodies. We've worked out a special deal with Hayya for their best selling children's vitamin. Receive 50% off your first order to claim this deal you must go to Hiyahealth.com Newsworthy this deal is not on their regular website. Go to h I y a H-E-A-L-T-Comnewsworthy to get your kids the full body nourishment they need to grow into healthy adults. Now back to my conversation with Dr. Celine Gounder. What about the changes to the rest.

[C]

Of the vaccine schedule? In terms of the CDC's recommendation, what do you think parents need to know about all the other diseases that have now been taken off that recommended schedule?

[B]

So you now have two different sets of guidelines. One from the American Academy of Pediatrics, which is essentially what the CDC used to recommend up until the Trump administration. And you have the CDC recommendations. The fact that you have two sets of guidelines is really unprecedented. The AAP and the CDC used to very much align and promote recommend the exact same guidelines. The AAP is not a fringe voice. It represents almost 70,000 pediatricians as well as other pediatric specialists. And their new schedule has been formally endorsed by 12 other major medical organizations representing over a million clinicians across the country. What are parents supposed to do with this? Well, you should feel empowered to ask your pediatrician or family doctor what schedule they are following for your child and why. And some of the specific things you may want to ask about are hepatitis B vaccine at birth for parents who are currently expecting, as well as flu, Covid and RSV vaccines. And if for whatever reason your pediatrician is diverging from what the American Academy of Pediatrics is recommending, ask them why and how they plan to make sure that your child gets all the necessary vaccines.

[A]

Yeah, because to be clear, kids can.

[C]

Still get all the vaccines and usually covered by insurance. Right. Even with the changes in the recommendations from the cdc.

[B]

Yeah. So insurance coverage is normally anchored to the CDC and federal policy, not AAP guidance. But at least right now, the insurance companies have said that through at least 2026, they will continue to cover all of the vaccines that the American Academy of Pediatrics is now recommending. However, you may still want to double CH with your specific plan to confirm that that remains the case.

[A]

I want to ask you before we wrap up here about the measles.

[C]

I know the measles mumps and rubella vaccine is still recommended by all the organizations we've discussed.

[A]

But where do things stand right now.

[C]

With the outbreaks that we first started seeing most recently, what, almost a year ago?

[B]

At this point, what's really concerning is that there are huge proportions of the country that are under vaccinated for MMR right now. A recent study that was published in Nature Health found that in some counties the coverage may be even lower than 60%. And we've seen at the same time an increase in non medical exemptions over the past decade, accelerating during the course of the pandemic. And so this leaves us highly susceptible to measles outbreaks. We can expect more outbreaks over the coming months. There was also a study recently published in the Annals of Internal Medicine looking at public health databases maintained by the cdc and some of those were not updated for months, six months plus. And so that kind of pause in public health data is highly concerning because that's exactly the kind of data you want in the middle of a measles outbreak or other outbreak so that you know how to respond, where to respond, how to target your resources, whether that's education or measles vaccination or other things like medical care for kids who have gotten measles. It does beg the question, how well prepared are we going to be as we see more and more measles outbreaks?

[C]

I sense a bit of frustration from public health experts who are seeing some of these vaccine numbers decline.

[A]

Can you explain how you're feeling about it?

[B]

Look, vaccines are some of the cheapest health care interventions and some of the most cost effective health interventions we have, other than maybe clean water and sanitation. And so if you care about preventing illness, if you care about saving lives, and if you care about doing that efficiently with the resources you have, vaccines are a no brainer. And so it is frustrating to see the reluctance to use a tool that we know works. And it's highly effective and safe to have that tool discarded by so many.

[A]

Thank you so much to Dr. Celine Gounder for sharing her expertise and insights with us. Please join us again during the week to stay updated and informed on the day's news. We provide daily roundups that are less than 15 minutes every Monday through Friday. And if you want to support the work we do here, we'd love for you to become a newsworthy insider. In addition to supporting us in a crucial way, you'll get completely ad free episodes, saving you more time and ensuring no interruptions to your news. Just go to thenewsworthy.cominsider to start your free seven day trial. That's thenewsworthy.cominsister. thank you so much again for listening. We'll be back on Monday with the latest news to know. Until then, have a great rest of your weekend.