Major oversight? U.S. child care centers rarely require flu vaccinations for kids or employees

PITTSBURGH — Coming down with a case of the flu is never fun, no matter your age, but a flu diagnosis in a young child can be especially detrimental to their health. Children are much more susceptible to the influenza virus, and more at risk of developing complications from the illness. That’s why the findings of a new study focused on U.S. child care center health standards are so surprising: these day care establishments rarely require attending children, or the caregivers looking after them, to be vaccinated against the flu.

“When kids are in close proximity to each other in child care centers they spread infectious diseases very efficiently,” comments lead author Dr. Timothy R. Shope of UPMC Children’s Hospital of Pittsburgh, in a release. “The interventions that we use for older children and adults to prevent influenza, such as maintaining a distance of 3 feet between individuals, and coughing or sneezing into a shoulder or an elbow, don’t work very well for a 2-year-old. So the best way we can protect them is through immunization.”

According to the CDC, everyone over the age of six months old should receive a flu shot every new flu season. However, this new set of research finds that only 24.5% child care directors currently enforce an influenza vaccination policy for attending children. More over, only 13.1% of studied directors have such a policy for their employees.

The research was conducted via a 2016 telephone survey encompassing 518 directors across 48 states. All of the participating child care centers were randomly selected from a national database of child care facilities.

The study’s authors were also curious to see if they could predict which child care centers mandated flu vaccinations based on a number of factors. Such factors included individual center quality ratings and reviews, previous flu outbreaks at specific centers, directors’ years of experience, and vaccine laws across states. Interestingly, only state laws were found to be an accurate predictor of directors requiring all attending children to be vaccinated.

“We can’t depend on child care directors’ experience or knowledge for implementing their own influenza vaccine requirements,” Dr. Shope says. “If we’re concerned with the public health of children and preventing influenza morbidity and mortality, we have to legislate the issue.”

Only four states (Connecticut, New Jersey, Rhode Island, and Ohio) currently have laws mandating all children attending day care be vaccinated. Within those four states, directors were much more likely to institute their own vaccination requirements for kids in comparison to other states. Perhaps predictably, directors who had a flu vaccine requirement for children were also found to be more likely to have the same requirement for their adult caregivers.

“For parents, they don’t need to wait until there is an influenza vaccination requirement for children in child care,” Dr. Shope concludes. “They should do what is best for their child’s health and get them immunized.”

The study is published in the Journal of the Pediatric Infectious Diseases Society.