What’s the Latest with the Flu in an Era of COVID-19, February 2021


Seasonal Influenza activity remains lower than usual.  The first novel influenza A virus infection of the current season was reported in January

Influenza activity during the 2020-2021 season has remained unusually low. In fact, a typical seasonal pattern with peak of influenza activity in February did not occur this year, as SARS-CoV-2 circulation predominated during the winter. Multiple factors are thought to contribute to this remarkable change in influenza circulation, and as such, it is not possible to predict how the next influenza season will behave based on these observations. Among the few isolated influenza strains identified in clinical laboratories, influenza B virus seems to be predominant. While uptake of influenza vaccine during the 2020-2021 season has been similar to that of previous seasons, the low number of influenza cases reported so far does not permit estimates of vaccine efficacy at this time. Updates are expected at the end of the season.       

In January, the first human infection with a novel influenza A virus in 2021 was reported in Wisconsin. The person (<18 years of age) was infected with a new influenza A(H3N2) variant virus. Variant influenza viruses are influenza viruses that normally circulate in swine and not people. The child was not hospitalized and has fully recovered.

Early identification and investigation of human infections with novel influenza A viruses is critical for understanding of risk of infection and implementation of appropriate public health measures. Additional information on variant influenza can be found at Information on Swine/Variant Influenza | CDC. Information regarding human infections with novel influenza A virus can be found at Novel Influenza A Virus Infections | CDC.

AAP State Data Reports of COVID-19 in Children (Updated weekly)

State-level reports are the best publicly available on child COVID-19 cases in the United States. The American Academy of Pediatrics and the Children's Hospital Association are collaborating to collect and share all publicly available data from states on child COVID-19 cases. Check for weekly updates here.


The 2021 Immunization Schedules are now available for children, adolescents, and adults. The schedules have been updated to reflect changes in vaccine recommendations in the past year related to the influenza and meningococcal vaccine. You can find more information about changes to the 2021 schedules in Pediatrics and AAP News.

Information on AAP influenza policy, practice policy, and administration of the influenza vaccine during the 2020-21 influenza season, can be found in the AAP Influenza Implementation Guidance.


The recently revised AAP Education in Quality Improvement for Pediatric Practice (EQIPP) Immunizations – Strategies for Success course is designed to enhance your immunization delivery system within your practice. Course participants will learn strategies to measure immunization rates, identify barriers to immunization, and implement interventions to increase immunization rates through the use quality improvement techniques.

The online course features two tracks; the 19-23 month old track and the adolescent track with data collection activities specific to each population. The course is eligible for Performance Improvement Continuing Medical Education, National Association of Pediatric Nurse Practitioners (NAPNAP) Continuing Education contact hours, and Maintenance of Certification Part 2 and Part 4 credits. The course is free to AAP members. Additional course information is available here.

For rural health care providers who are non-AAP members and interested in taking this immunization course, contact Melissa Ponce at mponce@aap.org to have your course fee waived through the Supporting Pediatricians to Improve HPV and Pediatric Influenza Vaccination Rates Initiative.


  1. Check out the newly updated AAP Immunizations Campaign and Toolkits page! There you will find helpful tools and resources on the importance and power of immunizations, including infographics and videos. Please use these tools to share pro-immunization messages with your networks. During flu season, join AAP in urging everyone to be vaccinated against influenza. Immunization is the best way to protect children and families. Suggested Hashtags: #VaccinesWork and #FightFlu.

  2. The AAP continues to add resources and content to its #CallYourPediatrician campaign toolkit. Take a look at the latest video added to the campaign, "Ready For This."

  3. Consider implementing one or more office-based strategies to improve immunization rates. More information is available at Office Strategies.

Additional Information 

See the AAP Red Book Online Influenza Resource pageAAP Red Book Online COVID-19,  and CDC FluView

This message is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $200,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. 

What's the Latest with the Flu for Early Child Care Providers and Educators

Find up-to-date information on the flu for early care providers.