Massachusetts first state to require students get flu shot

The mandate could set the stage for other states to enact similar measures; either way, school district leaders should be prepared to offer guidance to faculty and parents

On Wednesday, Massachusetts became the first state to require that all students – pre-K, K-12 and higher education – have an influenza vaccine as it tries to prevent what some health experts have labeled a “Twindemic” from happening later this year.

Will other states follow?

The Massachusetts Department of Public Health mandate states that any child ages 6 months and older, including those in child care, pre-K and kindergarten must be vaccinated by Dec. 31. That includes elementary and secondary students who are taking part in remote learning. Only those who are being homeschooled or are college students operating off campus through virtual learning are exempt from having a flu shot.

“The new vaccine requirement is an important step to reduce flu-related illness and †‹the overall impact of respiratory illness during the COVID-19 pandemic,” Massachusetts state officials said.

Physicians across the U.S. are urging people to get a flu shot this year and some states like Maine are starting the process in September. The Centers for Disease Control recommends flu shots be given by the end of October though are effective into January. Though it isn’t full-proof – 40-60% of those who get the vaccine do not have to see a doctor – the strategy is especially important this year to “not only reduce illness but to preserve scarce health care resources”, according to the CDC.

“Every year, thousands of people of all ages are affected by influenza, leading to many hospitalizations and deaths,” Dr. Larry Madoff, medical director of the Massachusetts Department of Public Health’s Bureau of Infectious Disease and Laboratory Sciences, said in a statement. “It is more important now than ever to get a flu vaccine because flu symptoms are very similar to those of COVID-19 and preventing the flu will save lives.”

Because many districts have chosen a hybrid model for learning this fall and most are targeting a return to in-person learning before the year ends, the CDC says it is especially important for children, who are in a high-risk category, to be vaccinated. More than 60 million students and faculty could return to school before flu season, and those shots can prevent 20% from getting the disease and causing further strains on an already overburdened health care system.

Guidance for school leaders

Despite the lead being taken by Massachusetts, it is expected to meet with resistance in other states and with individuals who want to have a choice of whether or not to get vaccinated. Even in those cases, school districts can be proactive in getting the word out to parents on the importance of staying healthy and encouraging flu shots.

The CDC offers a number of guidelines for school administrators on its website to impart to staff, parents and students, including:

  • Encouraging all those who come into contact with a school to get a yearly flu vaccine;
  • Encouraging preventive measures to mitigate the potential spread of the flu virus, such as staying home when sick, covering coughs, having flexible sick policies, providing adequate supplies and promoting overall health and hygiene, especially hand-washing and in the case of Covid-19, social distancing when possible;
  • Providing education materials that discuss what to do when someone gets sick, including options for students to remain at home when sick, separating sick students from healthy ones and highlighting the use of anti-viral drugs that may treat the flu;
  • Communicating well with local public health officials.

Although many districts are well-aware of proper hygiene strategies because of the coronavirus outbreak, the CDC does offers further insight to school administrators on the difference between cleaning, disinfecting and sanitizing. It also has further guidance such as forms and a recommendation letter that districts can give to parents.


Chris Burt is a reporter and editor for District Administration. He can be reached at [email protected]

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