March 22, 2017


Although influenza (flu) season typically begins to slow down by March, flu activity is still widespread across the US and there have been a total of 53 reported pediatric deaths associated with influenza during the 2016-2017 season. This serves as a sobering reminder of the importance of annual flu vaccination for all individuals six months and older, including healthy children.

Caroline Miller’s story emphasizes the need to prioritize annual flu vaccinations each and every year. So as you continue reading, pause for a moment and add a reminder to your calendar to get your family vaccinated against influenza during the upcoming season.

Caroline Miller2Caroline Miller was a very active and healthy 5-year-old. On December 18, 2012, Caroline came home from school with the sniffles and a mild cough. Caroline has mild asthma, but as the evening progressed, her breathing became more labored than usual and her parents contacted their pediatrician who recommended alternating doses of Caroline’s asthma medications and told her parents to stay in touch. Unfortunately, by 1 AM her condition had worsened. Caroline’s chest heaved as though she were running on the playground. After consulting with their pediatrician, her parents took Caroline to the local hospital. Within 48 hours of her initial symptoms of coughing and congestion, Caroline would be rushed from hospital to hospital to save her life.

At the first hospital, Caroline was diagnosed with influenza A and double pneumonia, and placed on oxygen as doctors monitored her breathing. The next day an ambulance took Caroline to a second hospital with a dedicated pediatric unit. She was prescribed antiviral medications, but her condition began to deteriorate, and she slipped further into life-threatening acute respiratory distress syndrome (ARDS). Caroline was immediately intubated, and she was transported via helicopter to a third hospital — Children’s Hospital of Philadelphia (CHOP). Once there, Caroline was put on an oscillating ventilator. This high frequency ventilation process serves to recruit lung tissue by never letting the alveoli completely collapse and has been developed to help patients with severely damaged lungs.

The list of what Caroline was facing was long and frightening. Flu, pneumonia, severe sepsis, septic shock, hypoxemia, and impending cardio-respiratory failure. Her small body was flooded with antibiotics – everything and anything to help her fight off the infections ravaging her lungs. Caroline would remain in the pediatric intensive care unit in a drug-induced coma, intubated, and on the oscillating ventilator for two weeks.

CarolineMillerOn Christmas Day, Caroline’s condition started to take a clear turn for the better. Each day between Christmas and New Year’s Day there were small signs of progress: the chest x-rays showed signs of clearing in Caroline’s lungs; her kidneys were functioning better; and her heartbeat was regular. Finally, her breathing improved enough that she was switched back to a conventional respirator. The recovery process was agonizing over the next several days, with two steps forward and one step back. Finally, on December 30, 2012 Caroline was taken off the paralytics and removed from the respirator. Caroline was able to leave CHOP a week later.

Caroline had been vaccinated against the flu every year except this particular year. The vaccine wasn’t readily available prior to the beginning of school and once the busy school year began, it fell off the “radar.” Caroline’s mother admits, “The fact that we neglected to make it a priority was the biggest mistake I’ve ever made as a parent. That mistake and lack of judgment nearly stole my child’s life and has changed our entire family’s lives forever.”

Thank you to the Miller family for sharing their story about Caroline’s experience with flu. Visit to learn more about preventing the spread of flu in schools.

To join the conversation, follow NFID (@nfidvaccines) on Twitter using the Keep Flu out of School hashtag #KFOS, like the Childhood Influenza Immunization Coalition on Facebook, join the NFID Linkedin Group, and subscribe to NFID Updates.