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School Flu Immunization Requirement 

Common Questions and Answers

Q: Why did the state health department make the influenza vaccine requirement only apply to children aged 24 months through 4 years (59 months)?

A: In the United States each year an average of 20,000 children younger than 5 years old are hospitalized because of flu complications. To reduce the risk of hospitalization from complications of influenza, the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) now recommend routine annual influenza vaccination of children older than 6 months. However, annual vaccination of all children aged 6 months–4 years (59 months) and older children with conditions that place them at increased risk for complications from influenza should continue to be a primary focus of vaccination efforts. By law, children age 6 months through 4 years who attend a licensed child care program and children age 24 months through 4 years who attend school must now receive an annual flu vaccination.


Q: Why is it required that the flu vaccine be given during a specific time frame?

A: Most flu vaccine is distributed to health care providers (HCPs) by October and November each year so most HCPs should have their supplies at that time.


We also know that public requests for flu vaccine peaks around September–December. 


If we can get a majority of children immunized within that four month timeframe, it will make monitoring the immunization status of a large number of children more manageable by the school or public health agency.


Q: What is the recommended dosing schedule for influenza vaccine?

A: According to the CDC recommended immunization schedule 2008, administer 2 doses (separated by 4 weeks or longer) to children younger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time last season but only received one dose. Only one dose is recommended per flu season thereafter for children 6 months and over. The CT immunization regulation requires at a minimum 1 dose of influenza vaccine for school entry, each year between August 1st and December 31. Click here for more information on influenza vaccines,


Q: How should a school enforce the flu vaccine regulation for those children who have not received the flu shot by December 31st?

A: Children who have not received the flu vaccine by December 31st must be excluded from school for the duration of influenza season (through March 31st) or until they receive at least one dose of the influenza vaccine.


Q: Do all children aged 24 months–4 years (59 months) who have not received a flu vaccine by December 31st need to be excluded from school?

  1. The school has received a statement signed by the child’s HCP indicating that the child has an appointment to receive the required immunization (this is considered “immunization in progress”). Continued enrollment in school for more than thirty days after the named immunization appointment shall be contingent on the school receiving written documentation from the HCP stating either: that the named appointment was kept and the child received the scheduled immunizations, or that the child was unable to receive the scheduled immunizations for medical reasons and a new appointment date is named;
  2. The school has received a statement signed and dated by the child’s HCP indicating that the child has a medical contraindication to immunization;
  3. The school has received a written statement that immunization is contrary to the religious beliefs and practices of the child or the parent of such child. Such statement shall be signed by the child's parent.

Q: Where can a family go to get the flu vaccine if the pediatrician does not have any more flu vaccine?

A: If a HCP cannot provide the flu vaccine within the given time frame of August 1–December 31st, documentation stating that the child has an appointment to receive the flu vaccine from his or her HCP would be acceptable. Barring that there is no national flu vaccine shortage and a HCP cannot guarantee an adequate supply of flu vaccine, other alternatives must be sought by the family. Options include: 


  1. Seeking out another HCP who can administer flu vaccine to children;
  2. Checking with the local health department to see if they administer flu vaccine to children of the necessary age and health insurance status;
  3. Checking your local newspaper for flu clinic listings and verifying that they have flu vaccine available for children of the necessary age and health insurance status.

Q: What if there is a flu vaccine shortage or a flu vaccine distribution problem?

A: In the event of a national or state vaccine supply shortage, as determined by the Centers for Disease Control and Prevention and the Department of Public Health Commissioner, respectively, the Commissioner or his or her designee may temporarily suspend the immunization requirement for the particular immunization affected by the supply shortage.


Q: How is the ‘flu season’ defined?

A:  Influenza season generally occurs during November through the end of March. 


Q: Is flu vaccine required after March?

A: No, students enrolling in school after March 31st are not required to get vaccinated but flu season may extend until May and therefore getting a flu vaccine even late in the season is still protective. 


Q: Is there flu vaccine available that does not contain the preservative, thimerosal?

A: Most single dose vials or syringes of influenza vaccine do not contain the preservative, thimerosal. The live, attenuated, influenza vaccine, (Brand Name: FluMist) given intra-nasally, is thimerosal-free. 


For a listing of thimerosal content in U.S. licensed vaccines, go to: https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/thimerosal-and-vaccines 


For more information about vaccine safety and thimerosal, go to:  https://www.cdc.gov/vaccine-safety/about/thimerosal.html


Q: Aside from the flu vaccination requirement for children 24–59 months, who else should get vaccinated for flu?

A: All people age 6 months and older are now recommended to receive annual influenza vaccination beginning with the 2010–2011 influenza season. Annual vaccination should begin as soon as the 2010–11 influenza vaccine is available.


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