Impact of Requiring Influenza Vaccination for Children in Licensed Child Care or Preschool Programs--Connecticut, 2012-13 Influenza Season

Preschool-aged children are at increased risk for severe influenza-related illness and complications. Congregate child care settings facilitate influenza transmission among susceptible children. To protect against influenza transmission in these settings, in September 2010, Connecticut became the second U.S. state (after New Jersey) to implement regulations requiring that all children aged 6-59 months receive at least 1 dose of influenza vaccine each year to attend a licensed child care program. To evaluate the impact of this regulation on vaccination levels and influenza-associated hospitalizations during the 2012-13 influenza season, vaccination data from U.S. and Connecticut surveys and the Emerging Infections Program (EIP) were analyzed. After the regulation took effect, vaccination rates among Connecticut children aged 6-59 months increased from 67.8% during the 2009-10 influenza season to 84.1% during the 2012-13 season. During the 2012-13 influenza season, among all 11 EIP surveillance sites, Connecticut had the greatest percentage decrease (12%) in the influenza-associated hospitalization rate from 2007-08 among children aged ≤4 years. Additionally, the ratio of the influenza-associated hospitalization rates among children aged ≤4 years to the overall population rate (0.53) was lower than for any other EIP site. Requiring vaccination for child care admission might have helped to increase vaccination rates in Connecticut and reduced serious morbidity from influenza.