fb-pixel Skip to main content

Flu shot mandate a crucial public health move during pandemic

Other states should follow Massachusetts’ lead in requiring that most students under 30 get a flu vaccination as part of their COVID-19 strategy.

Nicole Connell of Sutton holds the hand of her daughter Willow, 6, as she stands beside her two sons Caidon, 14, and Colton, 13, during a rally held outside of the Massachusetts State House to demonstrate against Governor Charlie Baker's order for mandatory influenza vaccinations for all students under the age of 30.Jessica Rinaldi/Globe Staff

What is worse than having one highly contagious, potentially deadly virus circulating widely?

How about two?

With flu season upon us, that is exactly what’s about to happen. COVID-19, which has now killed about 9,000 people in Massachusetts, isn’t going anywhere. And fearing that two simultaneous infectious diseases will overwhelm the state’s health care resources, Massachusetts public health authorities announced an unprecedented order requiring that most students get the influenza vaccine, which has historically been optional. It’s a sensible step in the midst of an already devastating pandemic.

The state’s mandate requires all children 6 months of age or older enrolled in child care, preschool, K-12, and colleges and universities to get a flu shot by the end of the year — unless they claim a religious or medical exemption, are home schooled, or are higher-education students who are off-campus and enrolled in remote-only classes. Enforcement will be carried out by the local school districts and higher-ed institutions.

A handful of other states require flu immunization for child care or preschool entry, according to state Secretary of Health and Human Services Marylou Sudders. But Massachusetts is the first state in the nation to enact such a sweeping order.


“A lot of the flu symptoms and COVID-19 symptoms are similar,” Sudders said. “And so we wanted to be able to diagnose appropriately. What’s flu, what’s COVID-19. And protect our health care resources. About 55,000 people every year end up in our hospital emergency departments with flu-like symptoms. . . . [That’s] a lot if you’re in the middle of a pandemic.”

The state has already requested a higher-than-usual number of flu shots from the federal stockpile: 1.2 million doses, which represents an increase of about 30 percent compared with previous years.

Naturally, the vaccine mandate has been controversial. A small but highly vocal anti-vaccine group organized a protest, and a couple of hundred parents and their kids showed up at the State House to demand that Governor Charlie Baker rescind the mandate. They carried signs that read, “Parents call the shots,” “Stop government overreach,” and “My kid, my choice.”


To be clear, state law gives the Department of Public Health the authority to establish what immunizations are required for school enrollment. The flu shot mandate is not government overreach — it’s about “our collective responsibility to stay as safe as possible and healthy as possible,” Sudders said.

“When you don’t vaccinate, when you choose to make yourself vulnerable, you’re not making only a choice for yourself but for others,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “Is it your right to catch and transmit an infectious disease? No.”

Massachusetts boasts of having the highest flu vaccination coverage in the country for those age 17 and younger: About 81 percent got the vaccine during the 2018-2019 flu season, according to the Centers for Disease Control and Prevention. But that 19 percent could present a real danger amid the coronavirus pandemic, especially as students begin to return to classrooms.

Last year, tens of thousands of people died of influenza, while COVID-19 has taken the lives of more than 180,000 Americans. Although the rate of Massachusetts’ coronavirus infections is low and stable, the specter of a second wave lingers as the state continues to reopen slowly. The convergence of the two viruses could very well create a perfect storm that would cripple hospitals and emergency rooms all across the state, affecting not just flu or COVID-19 patients but also all other patients who require hospitalizations.


One of the most compelling lessons from the first wave of coronavirus infections is that public health authorities must be proactive rather than reactive. Winter is coming, and the more states that follow the Commonwealth’s lead by mandating flu vaccinations for students, the better equipped the country as a whole will be for whatever lies ahead.

Editorials represent the views of the Boston Globe Editorial Board. Follow us on Twitter at @GlobeOpinion.