NEW YORK — How bad is this flu season, exactly? Look to the children.
Twenty flu-related deaths have been reported in kids so far this winter, one of the worst tolls this early in the year since the government started keeping track in 2004.
But while such a tally is tragic, that does not mean this year will turn out to be unusually bad. Roughly 100 children die in an average flu season, and it's not yet clear the nation will reach that total.
The deaths this year have included a 6-year-old girl in Maine, a 15-year-old Michigan student who loved robotics, and 6-foot-4 Texas high school senior Max Schwolert, who grew sick in Wisconsin while visiting his grandparents for the holidays.
He was kind of a gentle giant whose death has had a huge impact on his hometown of Flower Mound, said Phil Schwolert, the Texas boy's uncle.
Health officials started tracking pediatric flu deaths only nine years ago, after media reports called attention to children's deaths. That was in 2003-04 when the primary flu germ was the same dangerous flu bug as the one dominating this year. It also was an earlier-than-normal flu season.
The government ultimately received reports of 153 flu-related deaths in children, from 40 states, and most of them had occurred by the beginning of January. But the reporting was scattershot. So in October 2004, the government started requiring all states to report flu-related deaths in kids.
Other things changed, most notably a broad expansion of who should get flu shots. During the terrible 2003-04 season, flu shots were advised only for children ages 6 months to 2 years.
That didn't help 4-year-old Amanda Kanowitz, who one day in late February 2004 came home from preschool with a cough and died less than three days later.
The worst day of our lives, said her father, Richard Kanowitz, a Manhattan attorney who went on to found a vaccine-promoting group called Families Fighting Flu.
The Centers for Disease Control and Prevention gradually expanded its flu shot guidance, and by 2008 all kids 6 months and older were urged to get the vaccine. As a result, the vaccination rate for kids grew from under 10 percent back then to around 40 percent today.
Flu vaccine is also much more plentiful. Roughly 130 million doses have been distributed this season, compared to 83 million back then. Public education seems to be better, too, Kanowitz observed.