Hinman A R
Rev Infect Dis. 1986 Jul-Aug;8(4):573-83. doi: 10.1093/clinids/8.4.573.
Several diseases that now can be prevented by vaccines (diphtheria, measles, mumps, poliomyelitis, and rubella) have historically been widely transmitted in settings where children first congregate--primarily schools. Increasingly, children are brought together at younger ages in day care centers, and instances of these diseases have been recorded in day care settings. However, there have been few major outbreaks because of high immunization levels in these children. In 46 states, laws require immunization of children attending licensed day care facilities. Surveys show that children in day care have higher immunization levels than children of the same age who are not in day care. Because staff in day care can acquire and transmit communicable diseases, it is important that they also be immune.
现在可以通过疫苗预防的几种疾病（白喉、麻疹、腮腺炎、小儿麻痹症和风疹）在历史上曾在儿童首次聚集的场所——主要是学校广泛传播。现在，越来越小的儿童就在日托中心聚集在一起，并且在日托场所已记录到这些疾病的病例。然而，由于这些儿童的免疫水平较高，很少发生重大疫情。在46个州，法律要求在有执照的日托机构中照顾的儿童必须接种疫苗。调查显示，日托中心的儿童比不在日托中心的同龄儿童免疫水平更高。由于日托中心的工作人员可能感染并传播传染病，所以他们也具备免疫力很重要。
