Measles passes 4,000 and Pennsylvania counts a fifth death, flu positivity at 3.6%: this week's vaccine plan
With flu test positivity climbing a fifth straight week to 3.6% and U.S. measles cases passing 4,000, this week's brief weighs a new comparison of high-dose and standard flu shots for older adults and lays out what a household should book now.
Flu season is officially under way, and it has started faster than last year. In the week ending October 3, clinical laboratories across the country tested 39,317 respiratory specimens and found influenza in 1,435 of them, a positivity rate of 3.6%. That is the fifth straight weekly increase, after 1.3%, 1.8%, 2.7% and 3.4% in the four weeks before it. 1
The same week, confirmed measles cases in the United States passed 4,000 for the year, and Pennsylvania's health department raised its count of measles-associated deaths to five. 23
The household to-do list has not changed: a flu shot for everyone 6 months and older, and two documented MMR doses for everyone who can receive them. What changed this week is how early the flu is arriving, how fast measles is still climbing, and one new piece of evidence about which flu shot an older adult should ask for.
Flu is climbing faster than it did last year
CDC published its Week 39 report on October 9, covering the week ending October 3. That week also opened the 2026–27 flu season, which CDC counts from October 4. 1
Clinical laboratories found influenza in 3.6% of specimens, up from 3.4% the week before. Public health laboratories confirmed 204 positives, 201 of them influenza A and 3 influenza B; of the 127 they subtyped, 125 were A(H1N1)pdm09 and 2 were A(H3N2). Early circulation is running heavily toward one of the two influenza A components this season's vaccine covers. No specimen carried H5 avian influenza, and no new human infection with a novel influenza virus was reported. 1
Outpatient clinics logged fever with a cough or sore throat in 1.8% of visits, up from 1.7% and still below the national baseline of 3.1%. Emergency departments recorded a flu discharge diagnosis in 0.6% of visits, up from 0.4%. Two jurisdictions moved from minimal to low activity, and four large metro areas reached high activity. 1
Hospitals reported 3,334 laboratory-confirmed flu admissions during the week, or 1.0 per 100,000 people, up from 0.8. The rate was highest among adults 65 and older at 3.3, then adults 50 to 64 at 0.9 and children 0 to 4 at 0.8. Influenza accounted for 0.1% of deaths in the week. 1
CDC also reported three influenza-associated pediatric deaths, all of which occurred during the 2025–26 season, in the weeks ending December 20, January 3 and March 28. The 2025–26 pediatric total stands at 198, up from 195. 1
The professional bulletin IZ Express, published by Immunize.org, put the week plainly in its October 6 issue: confirmed flu activity is rising at levels that last season did not reach until several weeks later in the year. Its advice to clinicians and families is to vaccinate now rather than wait for the season to build. 4
A 3.6% positivity rate in early October is the start of a flu season, not the middle of one. For a family it sets the timing: protection takes about two weeks to build after a shot, and CDC's target is to be vaccinated by the end of October. 5
Measles passes 4,000, and Pennsylvania counts a fifth death
CDC updated its measles page on October 9 with figures reported through October 8. The United States has recorded 4,080 confirmed cases in 2026, up from 3,887 a week earlier — the first time this year's count has passed 4,000, and the highest yearly total since 1991. Forty-two outbreaks have been reported, and 96% of cases, or 3,897, are outbreak-associated. 2
Hospitalizations reached 414, equal to 10% of confirmed cases, up from 9% a week earlier. Fifteen percent of cases in children under 5 were hospitalized, along with 14% of cases in adults 20 and older. The page still lists two deaths for 2026, marked as subject to change. 2
Pennsylvania's health department counts more. In its October 2 update, the state reported 977 confirmed cases across 39 counties, 195 hospitalizations, and five measles-associated deaths. The fifth death was a 20-year-old woman with leukemia. 34
The two death counts measure different things. CDC is still developing a standard measles-death case definition with the Council of State and Territorial Epidemiologists, so it reports deaths cautiously and revises them as reviews finish. Pennsylvania published its own definition — a death within 30 days of symptom onset in a person with clinical evidence of measles and a positive laboratory test, not due to an unrelated cause — and has confirmed five under it. Both counts can be right at once, because each answers a different question. 23
Pennsylvania's outbreak has also differed in who it is hitting. About 69% of the state's confirmed cases have been in adults, the opposite of the national pattern, in which children make up the large majority. Fewer than 1% of the state's cases were in people who had been fully vaccinated. 4
Cases remain concentrated in a few states. CDC's national page lists Pennsylvania at 1,105, South Carolina at 670, Utah at 535, Wisconsin at 207, Texas at 192, and Virginia at 178. Pennsylvania's own count stood at 977 on October 2, so it runs behind the national page because the state dashboard and the federal page update on different days from the same reports. 23
By week of rash onset, the national count has held in a high band since August: 230 cases in the week starting August 23, then 187, 225, 167, 177 and 116 through the week starting September 27, with 25 in the still-incomplete week starting October 4. CDC revises these weekly totals upward as reports arrive, so the most recent weeks keep growing. 2
The population-level picture is unchanged and still short of where it needs to be. Two doses of MMR are 97% effective at preventing measles. Kindergarten MMR coverage was 92.4% for the 2025–26 school year, down from 95.2% before the pandemic, leaving roughly 280,000 kindergartners without the community protection a 95% threshold provides. 2
What the week's new evidence says about high-dose flu shots for older adults
Adults 65 and older have several flu vaccines to choose from, but head-to-head comparisons in one large population have been scarce. A study posted October 6 on medRxiv, a preprint server, supplies one. A preprint has not yet been reviewed by other scientists, so read its numbers as the strongest evidence available this week rather than as settled fact. 6
Researchers from France's national health-data agency followed 13.8 million adults aged 65 and over through the 2023–24 flu season, using the country's national health data system. Of them, 5.7 million, or 41%, were vaccinated. The study compared a high-dose product with three standard-dose products, and both against no vaccination. 6
Vaccination was associated with a 39% lower risk of being hospitalized with influenza and a 45% lower risk of dying during such a hospitalization. The high-dose product did better than the standard-dose ones: 50% effectiveness against hospitalization versus 36% for the standard-dose products, a gap that was clearest in adults 70 and older, while overall protection declined with age. 6
The result comes from an observational cohort rather than a randomized trial, so it describes how the products performed in one country's older adults in ordinary use. 6
CDC already recommends that adults 65 and older preferentially receive one of three products — Fluzone High-Dose, Flublok Recombinant, or Fluad Adjuvanted — while noting that any age-appropriate flu vaccine works if none of those is in stock. The French cohort puts numbers on why that preference exists. 5
The journals, the pipeline, and the season's other shots
The three immunology journals this channel follows — Cell, Immunity, and Nature Immunology — published nothing during the week that touches a household vaccine decision. Their newest issues ran into cancer immunotherapy, mitochondrial biology and basic immune regulation, with no study that changes what a family should do this season.
CDC has no U.S. flu vaccine-effectiveness estimate for the 2026–27 season, and none can exist this early. Its vaccination-trends page, reported October 9, carries 2025–26 data through May 23 and states that updates for that season ended in May, and its effectiveness index lists seasons only through 2025–26. The newest U.S. figure remains last season's 36% overall, with a confidence interval of 33% to 39%. 789
The COVID-19 guidance is also unchanged. CDC's interim clinical considerations, posted September 23, remain the current advice: a 2026–27 COVID-19 vaccine for all adults 18 and older, two doses six months apart for adults 65 and older, and vaccination for children 6 months through 17 years with moderate or severe immunocompromise, with shared decision-making for other children. 10
On the product side, nothing moved. Moderna's mFLUSIVA remains approved for adults 50 and older, with the 65-and-older indication granted under accelerated approval based on immune responses and expected availability during the 2026–27 respiratory season; the company still offers no local stocking, price or coverage detail. Pfizer's newsroom showed no respiratory-vaccine release this week; its newest entries concern a breast-cancer drug approval, a quarterly dividend, and a vitiligo treatment. CDC's routine immunization schedule pages still carry the July 2, 2025 addendum. 111213
What to do this week
- Book flu shots for everyone 6 months and older, now. The season already opened on October 4 and positivity is rising faster than it did last year; protection takes about two weeks to build, and the target is to finish by the end of October. 15
- If someone in the house is 65 or older, ask for a preferred product — especially from age 70. Fluzone High-Dose, Fluad Adjuvanted, and Flublok Recombinant are the three CDC recommends preferentially; any age-appropriate flu vaccine is better than none if those are out of stock. 5
- Start a first-time flu shot for a young child now. Children 6 months through 8 years who need two doses should get the first as soon as vaccine is available, because the second comes at least four weeks later. 5
- Find the MMR records for school-age children and for adults. Two documented doses need no further action; one dose or no record is the gap to close with a pediatrician, a state immunization registry, or a county health department. Complete MMR at least two weeks before an international trip. 23
- Ask about RSV antibody for an infant born this spring or summer. The window that opened October 1 is when most clinics resume dosing for babies who were not protected at birth through maternal vaccination or an antibody product. 4
- Ask about the 2026–27 COVID-19 vaccine if anyone in the household is 18 or older or has a higher-risk condition. The updated guidance covers all adults, older adults with a two-dose schedule, and children with immunocompromise. 10
This brief provides general health journalism for U.S. families. A physician, pharmacist, or local public health department can evaluate individual medical histories and confirm clinic-specific product availability.
References
- 1
- 2Measles Cases and Outbreaks
cdc.gov
- 3
- 4IZ Express Issue 1897
immunize.org
- 5
- 6
- 7
- 8
- 9
- 10
- 11IR Insights: Introducing mFLUSIVA
modernatx.com
- 12Newsroom | Pfizer
pfizer.com
- 13
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