pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Mandatory Flu Vaccination For Daycare

Here’s an interesting bit of data for you – an actual result to prove the effectiveness of a law that was passed. Really, how often do we ever get proof of what legislators manipulate us into doing?

In September 2010, Connecticut became the second US state (after New Jersey) to require that children aged 6 to 59 months receive at least 1 dose of influenza vaccine each year in order to register in a state-licensed child care program. A year later children 24-59 months registering for pre-school had the same requirement for flu vaccination.

The March 7th issue of Morbidity and Mortality Weekly Report (MMWR), sent to physicians around the country, had some comparison data to cover the years 2009-10 and 2012-13. Immunization rates were up and hospitalization rates were down.

In the 2007-8 flu season, Connecticut (one of 11 data gathering sites in the Emerging Infections Program – EIP) had the third highest hospitalization rates for flu in children ≤ four years of age; in 2012-13 they were only 7th.

Additionally, researchers at Yale in New Haven studied the Hospitalization rates for the 55,640 children of those ages enrolled in licensed child-care centers.

Vaccination rates increased 16 points from the 68% prior to the regulation to 84% in 2012-13, similar to the 11.9% increase seen around the country and that was associated with a 12% decrease in influenza-associated hospitalizations among children aged 4 years and under.

We must remember that children under 4 are at a huge risk for having other complications if they contract the flu compared with older children. AND, that day-care settings are the “hot bed” for contracting all air-born illness, including influenza.

Immunizing children for day-care and pre-school kills two birds with one stone so-to-speak, because it not only prevents the child from contracting the disease making his life better; but, it also prevents them from spreading it to the rest of the family and the many others with whom he/she comes in contact – including the children too young for immunization. That, of course, makes everyone’s lives better.

Of course this studies data could be a bit understated as it is only available for licensed centers and not family run day care homes or preschools.

None of the western states have such a mandate yet – surprising because California is usually first to jump on this mandating stuff – but a yearly influenza vaccination for children 6–59 months has been recommended since 2006.

Any parent who needs to enroll a child in preschool or daycare is really taking a chance if they don’t immunize against flu – currently the national immunization rate is 70%.

[Morb Mortal Wkly Rep. 2014;63:181-185.]