Respiratory virus activity across the United States has climbed to high levels, driven by increases in influenza and respiratory syncytial virus (RSV) activity, according to the Centers for Disease Control and Prevention’s (CDC’s) weekly respiratory illness update. Meanwhile, COVID-19 levels remain relatively low but show signs of an uptick.

As respiratory illnesses surge and emergency department (ED) visits for influenza hit high levels, US government leaders and federal agencies continue to minimize the need for vaccines. This week, Health and Human Services Secretary Robert F. Kennedy Jr. told CBS News that it might be a “better thing” if fewer children receive the influenza vaccine, despite the fact that 289 children—about 90% of whom were not fully vaccinated—died of influenza-related causes in the 2024–25 respiratory virus season. 

Kennedy’s comment followed the announcement of drastic changes to the US childhood vaccination schedule, which slashed the number of recommended vaccines from 17 to 11. The influenza vaccine is among those no longer broadly recommended for children.

In an interview with The New York Times yesterday, President Donald Trump signaled his support for the changes, saying, “I think it’s good.” No new data or scientific evidence was presented when announcing the new vaccine schedule. Career staff at the CDC reported being “blindsided” by the change. 

Flu markers mixed

Some indicators of flu activity have decreased or remained the same for the week ending January 3 compared to the previous week. Last week, positive lab tests for influenza, for example, dropped from 32.9% to 24.7%. 

In the previous week, 8.2% of outpatient visits to a health care provider were for respiratory illness, compared with 7.2% of visits last week—the first decline the CDC has noted this season. New York City has likewise reported a declining number of flu cases after hitting its highest level in a decade in December. 

The number of jurisdictions reporting very high respiratory illness activity dropped from 48 to 44.

But seasonal flu activity remains high across the country, and elevated levels are expected to continue for several more weeks. Hospital admissions for the flu rose this week, with 39,945 admitted, up from 33,301 patients last week. Eight flu-related pediatric deaths were reported this week, compared with one last week, including Louisiana’s first child flu death of 2026, for a US season total of 17.

Today’s FluView report reflects eight new flu-related deaths in children nationwide, all in mid-December to early January. All were attributed to influenza A. Of the six deaths that had subtyping performed, all were caused by the H3N2 strain.

RSV levels elevated

RSV, long a leading cause of hospitalizations for children, is also elevated in many regions. Data show that ED visits and hospital admissions for children aged 0 to 4 years have increased this week. Vaccination coverage for both influenza and RSV remain “suboptimal,” according to the update. 

Other respiratory illness activity

COVID activity remains low at a national level, but activity is increasing, as indicated by the CDC’s National Wastewater Surveillance System. Pertussis (whooping cough) levels are lower than their peak in November 2024, although they remain at overall higher levels than before the COVID pandemic. 

Pertussis is highly contagious, and babies under age one year are at high risk for severe disease and complications. Vaccination is the best way to prevent complications from pertussis, but many Americans are confused or unsure about current vaccination recommendations. Pneumonia levels are elevated in some regions of the country. 

The CDC expects the 2025–26 respiratory disease season to have a similar number of hospitalizations from COVID, influenza, and RSV as last season.