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Flu shot mandate for Mass. students leaves key questions unanswered

Governor Charlie Baker.
Governor Charlie Baker.Barry Chin/Globe Staff

The state’s new first-in-the-nation rule mandating flu vaccines for students under age 30 is drawing nearly as many questions as plaudits from health and education leaders who said the initiative will help curtail illnesses, but they’re uncertain how it will operate or be enforced.

The regulation, announced by the Baker administration Wednesday, requires the vaccination for anyone 6 months or older in child care centers, preschool, K-12 schools, and colleges and universities, unless they have a religious or medical exemption, are home-schooled, or are a higher education student living off campus and taking remote-only classes.

Students are required to be vaccinated by the end of the year. And state Secretary of Health and Human Services Marylou Sudders said Thursday the rule will be permanent going forward, requiring such flu shots annually.

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Officials are worried that coronavirus may surge again in the fall when more schools and businesses reopen, and they fear concurrent outbreaks of influenza and COVID-19 could overwhelm the state’s health care system. By mandating the vaccines for students, officials hope to ease the burden on health workers because fewer flu cases means they will spend less time discerning whether coughs and fevers are the flu or coronavirus.

“I would hope people would understand this is an important part of how we continue to fight the [corona]virus here in Massachusetts,” Governor Charlie Baker said Thursday at a State House news briefing. “The more people who get the flu shot don’t get the flu and don’t wind up in the ER.”

Under the flu vaccine mandate, elementary and secondary students whose schools are pursuing remote-only models this fall are not exempt. About 30 percent have opted for a remote-only start, raising questions about how such school districts might enforce the vaccine mandate remotely.

“If you are fully remote, I don’t know how you would account for students,” said Tom Scott, executive director of the Massachusetts Association of School Superintendents. Scott said his organization received a short briefing from the Baker administration just before the new rules were announced, but is awaiting guidance from the state on how this will work.

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So, too, is the Coalition for Local Public Health, whose members include local health departments, which are typically relied on for community flu clinics, coronavirus contact tracing, and a host of other responsibilities.

“We were told there would be sufficient vaccine to implement this order,” said Carlene Pavlos, executive director of the Massachusetts Public Health Association, a member of the coalition.

Massachusetts has about 1 million children enrolled in K-12 schools, according to state records. About 81 percent of those age 17 and younger received a flu shot in the 2018-19 year — the highest rate in the nation — according to the Centers for Disease Control and Prevention.

There are another half-million students attending colleges in Massachusetts, which suggests the state will need thousands more doses to cover those now mandated to get flu shots.

“The federal government bought a ton of extra flu vaccine this year specifically because they would like to see states work to enhance and extend the number of people who actually get the flu shot,” Baker said.

Many colleges already host annual flu clinics for faculty, staff, and students, though most students don’t usually opt for a shot, said Richard Doherty, president of the Association of Independent Colleges and Universities in Massachusetts.

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But because state law already requires all newly enrolled full-time college students under age 21 to get a meningococcal vaccine, and colleges require proof of that vaccination at enrollment, Doherty said it would probably be fairly easy for them to tack on the annual requirement for the flu shot.

“It sounds to me like it would be a manageable assignment for schools,” he said.

But a vocal antivaccination group has launched a petition, calling on the state health department and state lawmakers to repeal the new flu vaccination mandate. Health Choice 4 Action, which says it has more than 17,000 signatures on its petition, is planning a rally against the mandate later this month at the State House.

Although Massachusetts may inspire other states to institute a similar flu vaccine requirement, so far they don’t seem to be ready to take that step.

Rhode Island, which ranks second to Massachusetts in the percentage of children vaccinated against the flu, is one of a handful of states in which child care and preschool students and staff are already required to get the shot. “Right now we are exploring different ways that we can help ensure that our flu vaccination rates are as high as possible for older students as well,” said Joseph Wendelken, spokesman for the Rhode Island Department of Health. Those measures include community flu clinics and offering flu shots at COVID-19 testing sites.

Av Harris, spokesman for the Connecticut Department of Public Health, said no decision has been made about a flu shot mandate. But the state has a federal grant to encourage flu vaccination. “We will soon be up with a major media campaign promoting flu vaccination statewide in multiple languages,” he said in an e-mail.

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Kay Lazar can be reached at kay.lazar@globe.com Follow her on Twitter @GlobeKayLazar. Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer.