State Legislation to Improve Flu Vaccination Rates

December 12, 2018|3:27 p.m.| ASTHO Staff

Last week, CDC celebrated National Influenza Vaccination Week to bring awareness to the importance of the flu vaccine. CDC recommends that everyone over the age of six months, unless advised otherwise by their healthcare provider, get an annual flu vaccine. Getting the flu vaccine not only reduces the risks of getting the flu but also lowers the risk of hospitalization and missing school or work and helps to protect those at the greatest risk of suffering flu-related complications, such as young children, older adults, and pregnant women. Despite the dangers from flu, the 2017-2018 flu season saw 2.2 percent fewer children aged 6 months to 4 years and 5.7 percent fewer adults aged 65 and older be vaccinated than the prior flu season. Also, by CDC estimates, over 79,000 people in the United States died from the flu during the 2017-2018 flu season.

State law is often used as a tool to improve flu vaccination rates. For example, during the 2018 legislative year, states enacted laws for the distribution of information about the flu vaccine by schools, child care facilities, and adult residential facilities, requiring certain healthcare and adult care employees to be vaccinated against the flu, expanding pharmacist scope of practice to administer the flu vaccine, and increasing access to the flu vaccine by hospital patients.

Informing Parents and Older Adults

In Illinois, SB 2654 requires school district to include information about the flu and flu vaccinations when information about other vaccinations and infectious diseases is provided to parents or guardians. Louisiana adopted HB 74 directing schools to distribute information about the flu and flu vaccination that is developed by the state health agency. With SB 45, Alabama now requires child day care centers to provide flu and flu vaccine information to parents.

In Illinois, HB 4440 directs the state health agency to provide adult care facilities with educational information on all vaccines recommended by CDC’s Advisory Committee on Immunization Practices. Next door, in Indiana, HB 1058 was adopted requiring adult care facilities to provide residents with certain information about flu and flu vaccinations.

Healthcare and Adult Residential Facility Employees

In Delaware, HB 431 requires certain adult care facilities to offer annual flu vaccinations to employees who have direct contact with patients. The facilities are to keep records of which employees accepted and declined the vaccination and the law doesn’t make employment contingent on getting vaccinated. With HB 2984, Illinois added medical and religious exemptions to the law which allows the state health agency to require that licensed facilities implement a flu vaccination program for employees.


In Missouri, SB 826 lowers from twelve to seven the age of a patient to whom a pharmacist can administer a flu vaccine pursuant to a written protocol authorized by a physician. With SF 2322, Iowa authorizes pharmacists to administer flu vaccines pursuant to a statewide protocol to any patient over the age of 6 months.

New York enacted A 9507 to require educational materials on flu vaccinations for children be included in the areas pharmacists provide for patients when they receive vaccines. The content of the material is to be determined by the state’s education and public health commissioners. The bill also allows a pharmacist, as directed by a healthcare provider or the state health commissioner, to administer the flu vaccine to children between the ages of two and eighteen.

Hospital Discharge

In Rhode Island, SB 2226 and HB 7569 were passed directing hospitals to offer from October through May inpatients who are 65 years of age and older the flu vaccine prior to discharge. The offer is made contingent upon the availability of the vaccine and in accordance with CDC recommendations.

As flu season continues into next year, ASTHO will continue to monitor the activity of state legislatures as they enter new legislative sessions and seek to improve the access to and availability of flu vaccinations.

Tell us what you think icon that links to blog evaluation form