Flu positivity hits 9.1%, measles reaches 5,182, and a dairy worker dies of bird flu: this week's vaccine plan
Flu positivity reached 9.1% in a ninth straight weekly rise, measles reached 5,182 with a fourth death, and a Washington dairy worker died of bird flu; two new studies measure what a flu shot does for a child and to a shoulder.
Clinical laboratories tested 51,351 respiratory specimens in the week ending October 31 and found influenza in 4,696 of them. That is 9.1% positive, the ninth consecutive weekly increase. 1
The climb runs 1.3%, 1.8%, 2.7%, 3.4%, 3.9%, 5.0%, 5.7%, 7.6%, and now 9.1%. 1
Confirmed measles cases reached 5,182 as of November 5, with four deaths listed nationally. 2 Two Washington dairy workers were reported infected with A(H5) bird flu this week, and one of them died. 1
The household list keeps its shape: a flu shot for everyone 6 months and older, two documented MMR doses, and every routine childhood dose current. Four things bear on that list this week: the speed of the flu climb, the children in the season's toll, the dairy worker's death, and two new studies on the shot.
Flu has climbed for nine weeks without a break
Hospitals reported 8,396 laboratory-confirmed flu admissions in Week 43, a rate of 2.5 per 100,000 people. The week before ran 1.8. 1
Adults 65 and older were admitted at 7.9 per 100,000, adults 50 to 64 at 2.4, and children under 5 at 2.3. 1 Regional rates ran from 1.0 per 100,000 in Region 7, across the Midwest, to 3.4 in Region 4, the Southeast. 1
A second system, FluSurv-NET, follows select counties in 14 states and about a tenth of the population. Its sites reported 2,247 hospitalizations between October 4 and October 31, and its Week 43 rate was 1.6 per 100,000. 1 CDC expects that rate to settle between 2.2 and 2.9 once late reports arrive. 1
FluSurv-NET's age breakdown shows where the risk sits. The rate was 19.8 per 100,000 among adults 65 and older, 6.5 among adults 50 to 64, and 5.1 among children under 5. 1 Age-adjusted, the highest rate fell among non-Hispanic Black people at 9.6 per 100,000, followed by Asian and Pacific Islander people at 7.1. 1
Outpatient clinics logged fever with cough or sore throat in 2.8% of visits, just under the national baseline of 2.9%. 1 Emergency departments recorded a flu discharge diagnosis in 1.7% of visits, up from 1.2%. 1
Illness is spreading across the map. Two jurisdictions now sit at high flu activity, up from one, and five at moderate, up from two. 1 Three metropolitan areas reached very high activity where none did last week, and 19 reached high where nine did. 1 Regions 4 and 10 are the only ones above their own baselines. 1
CDC still classifies this season as low in severity. Its preliminary in-season assessment rates severity low across all ages, and separately for children, adults 18 to 64 and adults 65 and older. 1
The same report repeats a caution it has carried for weeks: an early increase has not reliably led to a higher seasonal peak or greater overall severity. 1
Severity so far is low. The climb is also nine weeks long and unbroken, with Thanksgiving a little over two weeks away. CDC's forecasters expect national increases in both hospital admissions and flu-caused emergency visits for the week ending November 21, projecting 6,900 to 30,100 new admissions and 1.6% to 6.7% of emergency visits. 1
The season's running tally, by CDC's model: at least 1,700,000 illnesses, 25,000 hospitalizations and 1,400 deaths. 1
The shot still matches what is circulating. Of 147 A(H1N1)pdm09 viruses tested, 140, or 95.2%, were well recognized by antibodies raised against A/Missouri/11/2025-like, the H1N1 component of the cell-based, recombinant and mRNA vaccines. 1 All 35 A(H3N2) viruses tested were recognized by antibodies to A/Darwin/1415/2025-like, and all 33 B/Victoria viruses by antibodies to B/Pennsylvania/14/2025-like. 1
Genetically, 485 of the 486 A(H1N1)pdm09 viruses characterized since May 24 sit in subclade D.3.1.1, and 101 of 106 A(H3N2) viruses sit in subclade K. 1
CDC attaches its usual caution to the H1N1 result. Viruses in D.3.1.1 are splitting into groups with different changes in their surface protein, more diversity than CDC has seen among co-circulating A(H1N1)pdm09 viruses before. It is too early to say what that means for protection. 1
Treatment holds. Eight of 457 A(H1N1) viruses tested showed reduced inhibition by oseltamivir, none highly reduced, and none of 622 viruses tested showed reduced susceptibility to baloxavir. 1
A 2026–27 U.S. effectiveness estimate sits months away. CDC's vaccination-trends page, updated November 6, carries only last season's charts. 3 The effectiveness index ends at 2025–26, when the vaccine cut outpatient flu visits by 36%. 4
Three children this season
FluView reports five influenza-associated pediatric deaths this week. Two occurred during the current season. One fell in Week 40, the week ending October 10, and was associated with an influenza A virus that was not subtyped. The other fell in Week 42, the week ending October 24, and was associated with A(H1N1). 1
CDC's running total for 2026–27 now stands at three. 1
The other three belong to last season. Two occurred in Weeks 9 and 20 of 2026, both associated with A(H3) viruses, and one in Week 16, associated with B/Victoria. That brings 2025–26 to 202. 1
The report gives the week of each death and the virus type. It gives no state, no age and no vaccination record. 1
Deaths in children reach CDC weeks after they occur, because each case takes investigation. States often announce a death before the federal count shows it, and the federal figure is preliminary. 1
A dairy worker has died of bird flu
Two new human infections with A(H5) bird flu were reported to CDC this week, and one of the two patients died. 1
Both were adults working at commercial dairy farms in Washington where highly pathogenic A(H5N1) has been detected in cows. The patient who died developed respiratory symptoms in the week ending October 24, went to an emergency department, was hospitalized and died. The second had conjunctivitis. 1
Washington has now recorded three A(H5) cases among dairy workers. 1 CDC counts 74 human cases of A(H5) bird flu in the United States since February 2024, seven found through routine flu surveillance and 67 through monitoring people with animal exposure. 5
CDC has identified no person-to-person transmission of A(H5) in the United States, and it assesses the risk to the general public as low. 5 The cases have clustered among dairy and poultry workers. 5
For a household with no farm contact, this changes no vaccination recommendation. One published detail is worth knowing. A study in mSphere on November 6 found that acidifying unpasteurized milk to pH 3.6 with a 3% vinegar solution inactivated H5N1 within 60 minutes. 6
The authors tested it as a way for dairy farms to neutralize contaminated milk before disposal. Milk from sick cows does not enter the consumer supply, they write. The study is about waste handling on farms. 6
Measles at 5,182, and a fourth death
CDC updated its measles page on November 6 with figures reported through November 5. The national count is 5,182 confirmed cases in 2026, up 330 in a week, from 47 jurisdictions and 18 international visitors. 2
Forty-three outbreaks have been reported, and 96% of this year's cases are outbreak-associated: 3,608 from outbreaks that began this year and 1,385 from outbreaks that began in 2025. 2
The page lists four deaths, marked subject to change. CDC says it is working with the Council of State and Territorial Epidemiologists on a standard case definition for measles deaths. 2
Kindergarten MMR coverage is 92.4% for 2025–26, under the 95% threshold, which leaves about 280,000 kindergartners at risk. 2 Two doses of MMR are 97% effective. 2
Pennsylvania's count differs from the federal one, and the difference is worth knowing. The state's October 30 release reports 1,426 confirmed cases in 44 counties, 268 hospitalizations and five confirmed measles-associated deaths. 7 Four of those cases, under 1%, were in people who had been vaccinated. 7
So Pennsylvania alone counts five deaths while CDC counts four nationally. 27 Each figure answers a slightly different question: the state counts against its own criteria, and CDC's national number waits on notification and on the case definition still being drafted. The federal count is the one that will move as reviews finish.
The state also reports that nearly 20% of the people it identifies with measles have been hospitalized, and puts the death rate at one to three patients per 1,000 cases. 7
Vaccination there keeps running far above normal. Providers gave more than 56,000 MMR doses in September and more than 53,000 in the first four weeks of October, against a typical month of about 25,000. 7
What a flu shot does to a shoulder
A study published November 4 in JAMA Internal Medicine measured one of the known harms of vaccination: shoulder injury related to vaccine administration. 8
Kaiser Permanente Southern California followed 1,366,362 adults who received 1.9 million COVID-19 or flu vaccinations between August 2023 and April 2024. 8 The researchers counted 252 shoulder injuries among 1,830,636 vaccinations. 8
That works out to 1.84 cases per 10,000 COVID-19 vaccinations and 1.15 per 10,000 flu vaccinations, an adjusted difference of about 7 extra cases per 100,000. 8
The case definition matters for anyone reading this. It counted shoulder symptoms that began within seven days of the shot and were still present more than 30 days later. 8 A sore arm for a day or two is ordinary and clears on its own. A shoulder still painful a month after the injection is what the study counted, and it is worth reporting to the clinician who gave the shot.
Among adults 65 and older, the incidence was 2.11 per 10,000 for COVID-19 vaccination and 1.63 for high-dose flu vaccination, a difference the study could not distinguish from chance. 8
The authors set the small absolute risk beside the protection both vaccines give against severe disease and hospitalization, and say the two belong in the same conversation. 8
What the flu shot did for children in Canada
A second study answers the question parents of young children ask most, and it comes with a caveat: it is a preprint posted November 4 that has not been through peer review. 9
Researchers in the SPRINT-KIDS network analyzed 30,733 visits by children aged 6 months to 17 years at 14 Canadian pediatric hospitals, across the 2024–25 and 2025–26 seasons. 9
Against any influenza, the vaccine was 47% effective in 2024–25 and 53% in 2025–26. Against an emergency department visit it was 53% and 57%, and against hospitalization 33% and 48%. 9
Protection was weaker against influenza A than against B: 31% versus 75% in the first season, and 42% versus 64% in the second. 9 It was also weaker in children 10 to 17 than in younger children, particularly those with underlying conditions. 9
The 2025–26 season was dominated by a drifted A(H3N2) virus, subclade K, and the vaccine worked at those levels anyway. 9
One finding bears on timing. Protection against influenza A was detectable up to 90 days after vaccination, while protection against B lasted past 120 days. 9
Nearly all the influenza A subtyped this week was A(H1N1)pdm09, at 97.7%. 1 A dose given this week covers the next three months, which runs into February. A dose given in August has passed the point where this study could still measure protection against A. 9
The three immunology journals
Cell, Immunity and Nature Immunology again published nothing this week that changes a household vaccine decision.
Cell's November 2 and 4 issues ran a base-pair-resolution map of the MYC cancer gene 10 and two papers on how industrialization reshapes the human gut microbiome. 11 Its other papers covered a form of cell death underlying acute liver injury 12 and the fatty-acid switch between cellular senescence and ferroptosis. 13
Immunity published one paper, on reprogramming tumor cells into dendritic cells to build immune structures inside tumors. 14
Nature Immunology carried a single item, a commentary titled "Germinal centers as evolutionary islands." 15
Germinal centers are the structures where B cells mature into antibody producers after a vaccination, which puts the topic one step from every shot on the household list. The commentary reports no new finding that a family could act on this week. 15
Where the products and the guidance stand
Moderna's mFLUSIVA is unchanged since its August 5 approval. It is approved for adults 50 and older, with the 65-and-older indication granted under accelerated approval based on immune responses, and Moderna expects it to be available during this respiratory season. 16 Moderna has published no stocking, price or coverage detail.
Pfizer's two newest releases, both dated November 3, are its third-quarter results and the appointment of a chief financial officer. Neither concerns a vaccine. 17
ACIP, the federal committee that votes on vaccine recommendations, lists its next meeting as February 24–26, 2027. The October meeting was cancelled. 18
CDC's routine immunization schedule pages still carry the July 2, 2025 addendum. 19
COVID-19 guidance is unchanged since September 23. A 2026–27 vaccine is recommended for all adults 18 and older, and for children 6 months to 17 years with moderate or severe immunocompromise; other children reach it through shared decision-making. 20
One new document matters for households with an immunocompromised member. Immunize.org published a seven-page summary of COVID-19 dosing for people with moderate or severe immunocompromise on November 4. 21
The two sets of guidance inside it differ by one dose. CDC routinely recommends two doses of the current season's vaccine, six months apart, for people who have completed an initial series. The Infectious Diseases Society of America recommends one dose, and notes that a second likely extends protection. 21
The document lays out both schedules by age and by prior vaccination history, so a family can bring the question to the specialist who manages the condition. 22
What to do this week
- Book flu shots now, for everyone 6 months and older. Positivity stands at 9.1% after nine straight weekly rises, and protection takes about two weeks to build. 1 CDC's end-of-October target has passed, and a November dose still covers the months ahead. 23
- If someone is 65 or older, ask for a preferred product. Fluzone High-Dose, Flublok Recombinant and Fluad Adjuvanted are CDC's preferred choices for that age group. Any age-appropriate flu vaccine beats none when those are out of stock. 23
- Start a two-dose series for a young child who needs one. Children 6 months through 8 years getting flu vaccine for the first time need two doses at least four weeks apart, and the first belongs now. 23
- If flu hits your household, ask about antivirals early. This season's viruses remain susceptible to oseltamivir and baloxavir, and treatment works best started soon after symptoms begin. 1
- Put MMR records in hand. Two documented doses need nothing more. One dose, or no record, is the gap to close with a pediatrician, a state registry or a county health department. 2
- Tell the clinician if a shoulder still hurts a month after a shot. That timing is the definition of the injury the Kaiser study counted, and it is the detail that makes the case recognizable. 8
- If someone in the house is moderately or severely immunocompromised, ask about the COVID-19 dose count. CDC recommends two doses this season, six months apart; IDSA recommends one. 21
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
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16IR Insights: Introducing mFLUSIVA
modernatx.com
- 17Pfizer Newsroom
pfizer.com
- 18ACIP Meeting Information
cdc.gov
- 19
- 20
- 21IZ Express Issue 1901
immunize.org
- 22
- 23
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