Influenza B is hitting Australian children hard this flu season as vaccination uptake slows
The then-eight-year-old contracted Influenza B in 2019 and, what started with aches and pains in her legs, led to multiple organ failure.
"They had to drain 200 millilitres of fluid from her heart — it was struggling," her mother Stephanie Campbell said.
"I think the doctor's words were 'your daughter could die tonight'."
Millie was taken by rescue helicopter from Newcastle to Westmead Children's Hospital in Sydney but soon after arriving she went into cardiac arrest.
"It was very, very surreal, it actually felt like at the time it wasn't happening," Millie's dad, Ian Campbell, said.
"There was no indication she was going to survive," Ms Campbell said.
When the doctors told Millie's parents the underlying cause of her illness was Influenza B they were shocked.
"We were blissfully ignorant to the fact it can be a killer," Mr Campbell said.
"People always think, 'Oh it won't happen to our kids'."
Millie was fit, healthy and had no pre-existing conditions but had to spend weeks in intensive care and six months in hospital.
She had to learn to walk again and eventually had to have her left foot up to her ankle amputated because of peripheral circulation damage from being on life support for so long.
"Millie's recovery will be a lifelong journey … and seeing how severe the flu can be, our message is: really to talk to your medical practitioner about the vaccine," Ms Campbell said.
This year, Australia has seen much higher rates of Influenza B than last year, particularly in children aged five to 16 years old, despite Influenza A being the more prominent virus type.
Influenza A and B present similarly, but type B can be more severe in children. The influenza vaccine contains two strains of the A virus and two of the B.
"[Influenza B] often gets a reduced awareness due to influenza A, probably because A is normally associated with pandemics," said Patrick Reading, director of the World Health Organisation Collaborating Centre for Reference and Research on Influenza.
Children currently make up the highest proportion of Influenza B cases in Australian hospitals but the reason for that is unknown.
"It's a bit of a mystery. It's an association that we see, but we can't say there's something specific about the virus that means it infects more children over adults," Professor Reading said.
Flu vaccination rates have been sliding since the COVID-19 pandemic and the group most impacted by Influenza B — the five to 16-year-old age group — now have the lowest vaccination uptake of all ages.
"In 2022 we had high rates across all age groups and now we have so many unvaccinated people, which means we have a larger cohort of people who are susceptible to infection," Professor Reading said.
He said this fading immunity was putting significant pressure on the health system and the worst might be still to come.
"We see elevated [influenza] circulation throughout August, September and October, so it's definitely not too late to get vaccinated," he said.
Millie's parents had been strict with vaccinations but once she was over the age of five they believed she was less at risk of getting seriously ill from the flu.
Influenza vaccines are free under the National Immunisation Program (NIP) for specific groups considered to be at greatest risk, including children aged between six months and five years old.
Outside of that age group the vaccine costs around $25 and becomes free again for people 65 and over.
But the age restrictions may be confusing some people, said Julie Leask, a social scientist with a focus on vaccination and prevention of infectious diseases.
"I don't think the risk-based strategy is working well for Australia," Professor Leask said.
"When the vaccine is on the [NIP] it's a real signal to people that this vaccine is important and it's also a signal to health professionals to recommend the vaccine … we still unfortunately see some [doctors] saying the vaccine isn't a good idea for kids."
For a vaccine to be free for all it must be deemed cost effective by the Pharmaceutical Benefits Advisory Committee.
The committee has previously knocked back an application for a universal free flu vaccine but Professor Leask strongly supports the idea.
"I think the Australian government needs to consider whether we can make the flu vaccine free for everybody aged six months and over, because then it will become a bit more institutionalised into our systems and simple to communicate."
Research has found the most common reasons people don't get their children vaccinated include:
Throw in anti-vaccine rhetoric, which has ramped up since the Trump administration took office in the US, and it's a complex picture.
Over the last six months, US health secretary and anti-vaccine activist Robert F. Kennedy Jr has been recirculating disproved myths about vaccines causing autism and walked back COVID-19 vaccine recommendations for children and pregnant women.
Professor Leask is convinced Mr Kennedy's messaging will cut through in Australia.
"We are seeing from the US this kind of mainstreaming of misinformation … we will see the impacts of that to some degree in Australia," she said.
Millie now has a prosthetic left leg and while swimming was originally part of her rehabilitation program, it is now a central part of her life.
The now-14-year-old has become a competitive swimmer who has won multiple gold medals at national championships and qualified for the recent World Trials held in Adelaide.
She now has her sights set on the 2028 Paralympics in Los Angeles.
Millie's influenza battle has a hard-fought happy ending, but her parents are worried about Australia's changing attitude towards vaccination.
"This growing hesitancy seems to be driven by the inability of people to decipher between evidence-based information and misinformation on social media," Mr Campbell said.
"I understand the predicament because most people spend more of their life on social media but I would encourage people to speak with health experts.
"Vaccination benefits not only you but the community."
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Dr Allen said government intervention was long overdue and it would have to be significant. "What's needed now is a comprehensive suite of policies aimed at tackling housing affordability, economic insecurity, gender inequality, and climate change," she said. "A piecemeal baby bonus isn't going to get us out of this." She said potential parents had lost confidence in the future being a hospitable place for a child. "What we need now is not pro-natalist policies, but instead policies of hope, restoring hope," Dr Allen said. "Because at the core of it, that's what having children is about, a hope that tomorrow will be worth living. "Right now there's a significant lack of hope in the future."
