State's flu shot mandate draws praise and ire from parents

Joan Goodchild
Baystateparent Magazine

Each fall, Anne Gray, a Shrewsbury mom of two, heads to the annual flu shot clinic at her local pediatrician to get her boys, aged 12 and 13, vaccinated. 

“I’m aware that the efficacy of the flu shot varies each year, but I also understand that it can reduce the risk of flu illness and hospitalization,” she said. “The potential protection from the vaccine is important for keeping my kids safe and healthy, and therefore it's an annual vaccine for them and our entire family.”

Soon, more parents may be joining Gray and her kids at flu shot clinics. For some, it won’t be by choice. 

Massachusetts officials recently announced a new, first-in-the-nation flu shot mandate for students under age 30. 

Under the rule, anyone 6 months or older in child care centers, preschool, K-12 schools, and colleges and universities, will be required to receive the flu vaccination this year. And it must be administered before the end of the year.

The rationale for the requirement is that levels of COVID-19 may spike again. A coronavirus surge, coupled with seasonal influenza outbreaks, may overwhelm the healthcare system with an increase in hospitalizations and ER visits. 

Officials also note that since the symptoms of coronavirus and the flu are similar, they hope vaccinating children against influenza means it will require less time to discern whether symptoms like a cough or fever are one virus or the other.

“I see this as two-fold,” said Dr. Christina Hermos, a pediatric infectious disease doctor at UMass Memorial Medical Center, and an assistant professor at UMass Medical School. “We need to do everything in our power to limit flu this season. We don't know what will happen with COVID-19 and if numbers start to surge, we need to have available medical personnel and hospital beds available and cutting down in ED and inpatient flu numbers will help. Flu and COVID-19 have similar symptoms. When symptoms develop, children are out of school and adults out of work until a diagnosis can be made. If we limit the number of COVID-19 ‘mimickers’ circulating, it will help children stay in school and limit the number of tests requested for COVID-19-like illnesses.”

Hermos stresses that data confirms the flu vaccine is safe and effective for kids. Last year it was about 60 percent effective in preventing flu in kids, she noted.

The vaccine is also effective at preventing severe flu, which can lead to hospitalizations and deaths. Preventing flu in kids also helps limit its spread in the community, she said, and in particular, helps prevent the chances that an older person, who may not respond to the vaccine, becomes infected.

Forced into a decision

But, for a variety of reasons, some parents simply don’t want their child to get the flu. For some of them, there are ways to opt out.

Students who have a religious or medical exemption are not required to get the vaccine. And those who are home-schooled by parents or family, or are living off campus and learning in remote-only classes, are also not required to receive the flu shot. 

But many believe the opt-out options don’t reach far enough. The mandate has drawn backlash from several parents who are concerned about the vaccine and do not want to be forced into having their child receive it. After the announcement, a group known as Health Choice 4 Action launched a petition calling on the state’s health department and state lawmakers to repeal the flu shot rule. The group also held a rally in August at the State House.

“The decision to abstain from the flu shot is neither uncommon nor irrational. But now, it comes with the life-long consequences of losing access to education,” said Candice Edwards, executive director of Health Choice 4 Action. “Children and young adults in Massachusetts will be barred from daycare, school or college if they make the same reasonable choice a majority of American adults make every year--to decline the influenza vaccine. Keeping kids out of school has enormous costs and real risks. One might assume that the data for influenza vaccine is rock-solid and benefits clearly outweigh costs. Not so.”

Edwards urges parents opposed to the new mandate to start crafting emails and to call their local lawmaker to make their opinion be heard. 

“Parents who oppose the mandate must become involved in civil engagement in an effort to rescind the mandate,” said Edwards. “We advise them to respectfully write and call their legislators, the Governor, and the Massachusetts Department of Health to tell them to repeal the order by communicating and sourcing their opposition. Additionally, parents can attend peaceful protests and sign-on to the class action lawsuit against Governor Baker.”

Hermos said, like mask requirements in the wake of coronavirus, just about any mandate always draws some initial protest, but the benefits of the flu vaccine far outweigh any perceived risks. 

“One-hundred-eighty-five children died of flu last year and most of these were unvaccinated or under-vaccinated,” she said. “We are learning that children are likely not the main drivers of COVID-19 infection and outbreaks among adults, but children are known to readily infect adults with flu and contribute to community flu rates. Vaccine is the right thing to protect kids and the community at large.”