City Health Information
September 2012 New York City Department of Health and Mental Hygiene Vol.31(4):25-32



Influenza Prevention and Control, 2012-2013
  • Vaccinate everyone aged 6 months and older against influenza.

  • Vaccinate day care and school-aged children, who are key transmitters of disease, as early as possible.

  • Give inactivated vaccine to all pregnant women in any trimester.

  • Vaccinate all health care workers against influenza.

  • New health care worker vaccination reporting requirements for acute-care facilities will take effect in January 2013.


Influenza in children results in increased visits to clinics, emergency departments, and hospitals, increased use of antibiotics, school absenteeism, and lost parental work time (12,13). Children aged 6 through 59 months and children with certain medical conditions such as asthma and neurologic/developmental disorders are among those at higher risk for severe complications of influenza (Box 2) (11). Even without high-risk medical conditions (14), children younger than 5 years old, especially those younger than 2 years old, are at increased risk for hospitalization from flu (9,11).

Children in day care and school are a major source of influenza transmission in the community and should be vaccinated as early as possible (8-11). Vaccinated children in day care spread 42% less febrile respiratory illness to their unvaccinated household contacts--and 80% less to unvaccinated household contacts aged 5 through 17 years--compared with unvaccinated children in day care (10). School-aged children have the highest incidence of influenza (9,11), although the illness is often not diagnosed (15). It is estimated that a vaccination rate as low as 20% in school-aged children could potentially reduce mortality in adults aged 64 years and older more effectively than a vaccination rate of 90% in older adults (8).

Per recommendations from the Centers for Disease Control and Prevention (CDC), all children aged 6 months and older should receive at least 1 dose of seasonal influenza vaccine. Children aged 6 months through 8 years may also require a second dose of vaccine, administered at least 4 weeks after the first dose, for optimal protection against influenza disease. Children requiring a second dose include (16):

  1. All children who have not received at least 2 doses of seasonal influenza vaccine in the past.
  2. Children who have received 2 or more doses of seasonal influenza vaccine in the past, but did not receive at least 1 dose of seasonal influenza vaccine in either the 2010-11 or 2011-12 season or 1 dose of monovalent 2009 (H1N1) vaccine.