The U.S. Department of Health and Human Services this week removed the influenza shot鈥攁long with five others鈥�from the list of recommended vaccines for all children, an announcement that surprised some school health leaders as it comes during a particularly brutal flu season.
Vaccines against the measles, polio, whooping cough, and others remain recommended for all children. But the annual flu shot is now included in a separate group of shots鈥攁longside those that protect against meningitis and Hepatitis A and B鈥攖hat are recommended only after consultation with a health care provider鈥攁 designation the .鈥�
The change is likely to lead to confusion and an added burden for schools both in the short and long term as families decipher the guidance and some opt not to receive shots that help prevent outbreaks of common respiratory illnesses including influenza, COVID-19, and RSV, said Lynn Nelson, president of the National Association of School Nurses.
No longer recommending the annual flu shot to all might have the most immediate effect on schools, she said.
鈥淭he flu shot has always been optional, but to sow those seeds of doubt with parents just feels so irresponsible, especially in a season like this one where the flu is more contagious and making more people sick,鈥� Nelson said.
Health and Human Services Secretary Robert F. Kennedy Jr. said in a statement that the new vaccine schedule 鈥減rotects children, respects families, and rebuilds trust in public health.鈥�
The U.S. Centers for Disease Control and Prevention estimates that there have been at least 11 million illnesses, 120,000 hospitalizations, and 5,000 deaths from the flu so far this season, which runs through the fall and winter and typically peaks between December and February. Nine of the deaths have been among children, including one during the week that ended Dec. 27, according to
Forty-eight states are reporting high or very high flu levels, according to the CDC.
Last year鈥檚 flu season was also considered severe鈥攂y some measures the most intense in 15 years.
have the could with the return to school after the holiday break.
Some schools in , , , , , and either temporarily switched to online classes or closed buildings for at least one day in late December as the number of local flu cases among students surged.
One likely factor contributing to the increase in flu cases is that there has been a decline in flu vaccinations in recent years, Nelson said. That鈥檚 true even as public health experts have said this year鈥檚 vaccine doesn鈥檛 appear to match the predominant strain of the flu that is circulating.
Still, vaccines are effective at ensuring those who become infected do not become as severely ill or experience complications such as pneumonia that can land people in the hospital.
And for kids, there is evidence that even mismatched vaccines can protect them from contracting the flu in the first place, Nelson said, .
What schools can do to slow the spread
To help slow the spread of flu and other respiratory illnesses, schools should send reminders to parents via email or newsletters about when it鈥檚 necessary to keep kids home from school鈥攊f they have a fever, vomit, or have diarrhea, for example鈥攁nd remind them it鈥檚 important to not send their children if they have symptoms of contagious illnesses, Nelson said.
Schools should develop and frequently share clear with parents, especially during cold and flu season, she said.
And if parents have questions about the updated federal childhood vaccination guidelines, schools could direct them to their child鈥檚 pediatrician for guidance, Nelson said.
鈥淭hose partnerships and ensuring families feel like they can ask questions and get support will be very important,鈥� she said.
Schools should also remind teachers to take sick time if they need to and have substitutes at the ready to fill in.
Teachers are both uniquely vulnerable to, and can have more resilience to, seasonal bugs than the general population. They face a mountain of stress, which can reduce their immune system鈥檚 ability to ward off illnesses, and they鈥檙e exposed to all kinds of bugs in the classroom.
Compared with professionals in other fields, teachers are more likely to work through illness鈥攁nd many teachers also say they don鈥檛 feel empowered to take their available sick leave.
Teachers should ensure they鈥檙e up to date with routine vaccinations and take a little extra time to clean frequently touched surfaces in their classrooms.
