Metroka Amy E, Papadouka Vikki, Ternier Alexandra, Cheng Iris, Zucker Jane R
Bureau of Immunization, New York City Department of Health and Mental Hygiene, Queens, NY, USA.
Now retired.
Public Health Rep. 2025 Jan-Feb;140(1):5-12. doi: 10.1177/00333549241260166. Epub 2024 Jul 26.
In 2014, New York City initiated a childcare influenza vaccine requirement to increase influenza vaccination rates among children aged 6-59 months attending city-regulated childcare, including prekindergarten. We evaluated the requirement's effect on vaccination rates in childcare-aged children in New York City.
We examined influenza vaccination rates in children aged 6-59 months and by age groups of 1, 2, 3, and 4 years for 8 influenza seasons (2012-2013 through 2019-2020), representing 2 seasons before the requirement, 2 seasons during the requirement, 2 seasons after its suspension, and 2 seasons after its reinstatement. We also assessed rates in a comparison group of children aged 5-8 years. We performed a difference-in-differences analysis to compare rate differences in age groups when the requirement was and was not in effect. We considered < .05 as significant based on the Wald χ test.
Influenza vaccination rates among children aged 6-59 months increased 3.7 percentage points (from 47.7% to 51.4%) by the requirement's second year and declined 6.7 percentage points to 44.7% after suspension. After reinstatement, rates increased 10.7 percentage points to 55.4%. Rate changes were most pronounced among 4-year-olds, increasing 12.7 percentage points (from 45.3% to 58.0%) by the requirement's second year, declining 14.1 percentage points to 43.9% after suspension, and increasing 22.2 percentage points to 66.1% after reinstatement. In the comparison group, rates increased 4.9 percentage points (from 36.5% to 41.4%) after reinstatement. Rates increased significantly among 4-year-olds before versus at the initial requirement and decreased significantly after suspension. After reinstatement, rates increased significantly among all groups except 1-year-olds.
The New York City influenza vaccine requirement improved influenza vaccination rates among preschool-aged children, adding to the evidence base showing that vaccine requirements raise vaccination rates.
2014年，纽约市出台了一项儿童流感疫苗接种要求，以提高在该市受监管的儿童保育机构（包括学前班）中6至59个月大儿童的流感疫苗接种率。我们评估了这项要求对纽约市儿童保育年龄段儿童疫苗接种率的影响。
我们检查了8个流感季节（2012 - 2013年至2019 - 2020年）中6至59个月大儿童以及1、2、3和4岁年龄组儿童的流感疫苗接种率，这8个季节包括该要求实施前的2个季节、实施期间的2个季节、暂停后的2个季节以及恢复后的2个季节。我们还评估了5至8岁儿童这一对照组的接种率。我们进行了双重差分分析，以比较该要求生效和未生效时各年龄组的接种率差异。基于Wald χ检验，我们将P < 0.05视为具有统计学意义。
到该要求实施的第二年，6至59个月大儿童的流感疫苗接种率提高了3.7个百分点（从47.7%升至51.4%），暂停后下降了6.7个百分点至44.7%。恢复后，接种率提高了10.7个百分点至55.4%。接种率变化在4岁儿童中最为明显，到该要求实施的第二年提高了12.7个百分点（从45.3%升至58.0%），暂停后下降了14.1个百分点至43.9%，恢复后提高了22.2个百分点至66.1%。在对照组中，恢复后接种率提高了4.9个百分点（从36.5%升至41.4%）。在初始要求前与刚开始实施要求时，4岁儿童的接种率显著上升，暂停后显著下降。恢复后，除1岁儿童外，所有组的接种率均显著上升。
纽约市的流感疫苗接种要求提高了学龄前儿童的流感疫苗接种率，进一步证明了疫苗接种要求能提高接种率。
