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• Posted October 23, 2025

Why Vaccines Are Especially Important for Children With Asthma

You may have seen recent news stories reporting that a national data investigation found that routine childhood vaccination is slipping across much of the United States, leaving classrooms and daycares with growing gaps in protection against highly contagious diseases like measles and whooping cough.

That’s a warning sign for every family with children — and an even bigger one for children with asthma, whose lungs are more likely to suffer when infection strikes. 

Allergists are also immunologists. We are physicians trained to evaluate vaccine reactions and ingredients.

As an allergist and executive medical director of the American College of Allergy, Asthma & Immunology (ACAAI), I often explain to my patients and their parents why vaccines remain one of the best tools to keep vulnerable lungs healthy, what “herd immunity” really means and how to get reliable, allergy-informed guidance.

Herd immunity: why your shot protects your neighbor

Herd (community) immunity means enough people are immune, through vaccination or prior infection, that a virus struggles to spread, and those who can’t be vaccinated or have weaker immune systems are still protected.

Vaccination rates need to stay between about 92% and 95% to stop a virus from spreading. When rates fall below that level, outbreaks become far more likely.

Measles is one of the most contagious infections known. But the percentage of U.S. kindergarteners who have had two doses of the Measles Mumps Rubella vaccine (MMR) fell from about 95% in 2019–20 to 92.7% in 2023–24, leaving hundreds of thousands of children more exposed.

The consequences are already apparent: During the 2025 West Texas measles outbreak, 99 people were hospitalized and two school-aged children died from a largely preventable disease. 

The American Academy of Pediatrics (AAP) emphasizes the importance of following the recommended childhood immunization schedule to close those risk gaps. Vaccines don’t just protect you: They also protect your child’s classmates and your immunocompromised neighbor and help your child with asthma breathe easier.

The science behind vaccine recommendations

Every vaccine given in the U.S. undergoes rigorous clinical testing and ongoing safety surveillance. Guidance is updated annually to reflect the latest evidence. Keep in mind the following about vaccines for respiratory illnesses:

Influenza (flu) vaccine: Everyone 6 months and older should get a flu shot each year. People with asthma are at higher risk of severe flu complications: Flu can trigger asthma attacks, worsen symptoms and lead to pneumonia and hospitalization. Annual vaccination reduces those risks. 

Pneumococcal vaccines: Pneumococcal disease is especially dangerous for people with chronic lung disease, including asthma. A four-dose series of PCV15 or PCV20 is recommended for children under 5, and expanded use of PCV20 (or PCV15 + PPSV23) is recommended for adults, including those between 19 and 49 years of age with asthma.

MMR: A first dose of the MMR vaccine is recommended between 12 and 15 months of age, and a second dose at least 28 days later. (It is often given between 4 and 6 years of age.)

RSV protection: The AAP recommends protecting infants from RSV via maternal vaccination or infant immunization with nirsevimab during their first RSV season, which is typically from September through January.

• Pregnant women can receive the RSV vaccine (RSVpreF) between 32 and 36 weeks of gestation. This timing helps to pass protection to the infant before birth. The vaccine is recommended for pregnant women who do not have a planned delivery within the next two weeks and have not received the maternal RSV vaccine during the previous RSV season. 

• Infants under 8 months of age should receive monoclonal antibody immunization (nirsevimab or clesrovimab) during their first RSV season, ideally within the first week of life if born between October and March. This is especially if their mother was not vaccinated against RSV during pregnancy. 

• Children aged 8 through 19 months at increased risk for severe RSV disease should receive nirsevimab at the start of their second RSV season. AAP defines high risk as infants with chronic lung disease, those with compromised immune systems and other groups. Nirsevimab can be given at the same time as other routine childhood vaccines. 

Large-scale research also confirms that vaccines do not cause asthma or allergic disease. A 2021 meta-analysis of more than 5,000 children found no link between routine childhood vaccines and later asthma, eczema or hay fever.

What if I have food allergies or a history of reactions?

If you have a history of hives, wheeze after a prior vaccination or have questions about ingredients (e.g., gelatin, PEG), an allergist can test, choose alternatives, adjust the timing of certain vaccines and vaccinate under supervision when needed.

Most people with allergies can be vaccinated safely, with only a small number needing special evaluation. True vaccine allergies are extremely rare.

Decades of evidence also show people with egg allergy can receive any age-appropriate flu vaccine without special precautions. 

Why this especially matters for people with asthma

Respiratory infections are among the most common triggers of asthma flare-ups. Preventing those infections through flu, pneumococcal and other routine childhood immunizations lowers the chance of an asthma attack, emergency visits and complications.

For example, a 2023 study found flu vaccination lowered hospital visits among people with asthma by nearly 60%.  

When you schedule flu shots for the whole family, discuss your options with your provider first. The live attenuated influenza vaccine (LAIV) is commonly known as the nasal spray vaccine, and it is generally not recommended for people with asthma due to the risk for wheezing. Inactivated vaccines, however, are safer for people with asthma — including those on asthma biologics like dupilumab. Staying up to date on vaccines is part of good asthma control.

How ACAAI can help

• Evidence you can trust: ACAAI’s patient resources summarize the importance of vaccines for people with allergies and asthma and what the science shows about vaccine safety.  

• Find an allergist: Use ACAAI’s allergist locator to get personalized guidance on vaccine timing, product choice and managing prior reactions.

• Actionable plans: Allergists coordinate with your pediatrician or primary care clinician to keep you on schedule, document any precautions and reduce barriers (for example, scheduling same-day asthma and immunization visits).

Remember, vaccines are part of everyday asthma control alongside inhalers and management of triggers.

When your family, alongside kids at your child’s school, stays up to date on vaccines, it all helps every person with asthma breathe easier.

About the expert

Dr. Todd Mahr is the executive medical director at the American College of Allergy, Asthma & Immunology.