March 12, 2014
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Flu vaccination requirements for child care centers increased immunization rates

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In September 2010, Connecticut became the second state to require all children aged 6 to 59 months to receive at least one dose of influenza vaccine each year to attend a licensed child care program, according to an MMWR report.

New Jersey is the only other state with the requirement. However, New York City passed similar requirements in January.

“The reasons behind this discrepancy have not been studied,” the researchers wrote. “However, it might be, in part, because influenza vaccine is not widely available until well after licensed child care begins in August or September, when requirements are enforced. In addition, surveying of licensed child care centers and preschools for compliance usually takes place in October, when influenza vaccination often is just beginning. Thus, additional efforts are required to monitor and enforce compliance of entry requirements. In addition, because influenza vaccination has been available for decades but never required, it might be more difficult to convince parents and guardians of its necessity.”

After implementation of Connecticut’s requirement, influenza vaccination rates among children aged 6 to 59 months in that state increased from 67.8% during the 2009-2010 season to 84.1% during the 2012-2013 season. Connecticut had the highest decrease (12%) of influenza-associated hospitalizations from 2007-2008 to 2012-2013 among all 11 Emerging Infections Program (EIP) sites.

“Vaccination against influenza has gradually evolved from an elective annual event for selected groups at high risk for influenza complications to a recommended annual event for all persons aged ≥6 months. In congregate settings in which persons are at greater risk for both exposure and complications, such as child care programs and health care settings, the current recommendations call for most persons to be vaccinated,” the researchers wrote. “The Connecticut study might be helpful to public health agencies elsewhere considering requiring influenza vaccination of children in licensed child care programs and preschools.”

Disclosure: The researchers report no relevant financial disclosures.