NYC may mandate flu vaccines for all daycare, preschool students


A flu shot may soon be required for all New York City daycare and preschool kids.

New York City health officials will decide Wednesday whether to adopt a proposal that would require all children under 5 who are attending one of these childcare facilities to receive a flu shot by Dec. 31 of each year, before flu season peaks.

“A lot of people have a misconception that the flu is just like the common cold and nothing that needs to be worried about,” Dr. Jay Varma, deputy commissioner of the New York City Department of Health and Mental Hygiene, told CBS News. “In fact, flu is common and can be very serious for children under the age of 5,” he said.

Varma estimates the mandate would prevent more than 20,000 cases of flu in young kids. 

Under the proposal, a daycare or preschool can choose to exclude a child from their facility if he or she doesn’t get the vaccine. If the facility does not keep up to date vaccination records for its kids, it could be subject to a fine.

Mandating a flu vaccine for young children is uncommon. Varma noted that only New Jersey and Connecticut have similar requirements for some schools.

Mandates for other childhood vaccines, however, are more common. In New York City, children of these ages are already required to receive common vaccines including the MMR (measles, mumps, rubella), polio, pertussis (whooping cough), chickenpox and tetanus shots.

Varma says this will be just one more vaccine added to that list, except flu tends to hospitalize and kill more children each year than any of those conditions.

He estimates this mandate would cover about 150,000 New Yorkers younger than 5 years old.

The requirement won’t apply to family daycare, where someone watches children in their own home. The only allowable exemptions are medical, when people have rare side effects to vaccines or conditions that prevent them from receiving one, or religious, which would have to be verified by a religious official.

New York State does not allow philosophical exemptions, such as over fears of vaccine side effects. Varma said that’s a good thing, since philosophical differences were behind some reported upticks in diseases like measles for some parts of the country.

Flu season generally starts as early as October, with the number of cases increasing dramatically by December and the season often peaking from January through March, according to the Centers for Disease Control and Prevention.

A flu season can range in it’s severity, but children and the elderly are often hit hardest. In the previous 10 flu seasons before last year's epidemic, between 43 and 153 children have died from flu in the United States, according to federal estimates, with an average of 20,000

children under 5 hospitalized. A recent study found more than 40 percent of child flu deaths between 2004 and 2012 were in previously healthy kids without any preexisting chronic medical conditions.

Last year’s severe flu season -- which started a several weeks earlier than typical -- killed at least 165 children. So far, three children have died in the milder 2013-2014 flu season, according to CDC estimates.

The flu vaccine isn't perfect, as Varma concedes. A flu vaccine tends to have an effectiveness rate within the 60 percent range.

But, he says young children are especially at risk given they are surrounded by other little kids and may not be engaging in adequate hand-washing. He also pointed to potential community benefits, such as preventing disease transmission to other members of the family -- especially the elderly --  or keeping more kids at school and their parents at work.

The process to mandate flu vaccines for New York City’s young children started with a proposal the Board of Health considered in September, Varma explained. It was then opened to public hearing and comment. The Dec. 11 hearing is the period will the Board will hear the public comments and decide whether or not to formally adopt the measure, which would then be enacted 30 days after approval.

Given the end of December is weeks away, this mandate would go into effect until next year.

The city’s health department currently inspects these childcare facilities for safety violations, and Varma sees this as yet another way to ensure kids’ safety.

“We feel strongly that we are doing something that’s always been done to protect the health of children,” he said.