Why Aren't Flu Vaccinations Mandatory in NH Schools?

Barbara Pamboukes believes Portsmouth Schools have been a leader when it comes to giving flu vaccinations to students and members of the communities they serve.

"We have been offering flu vaccines in our schools for 20 years," said Pamboukes, who serves as the Portsmouth Schools Nursing Department director. The school district chooses to partner with the New Hampshire Department of Health and Human Services Immunization program in Concord to obtain the vaccines it needs, she said.

According to Dr. Jodie Dionne-Odom, the deputy director of epidemiology at the New Hampshire Department of Health and Human Services in Concord, there are many school districts throughout the state that choose not to do fall flu vaccination clinics.

"It's not mandatory," she said.

Meanwhile, the State of Maine right next door has a public health policy that requires all of its school districts to offer flu vaccination clinics in the fall and Dionne-Odom said Maine's inoculation rates are twice as high as New Hampshire's rates.

Dionne-Odom said in 2012, New Hampshire achieved a flu vaccination inoculation rate of 44 percent, which is 2 percent higher than the national average. Since Maine adopted a mandatory school district flu vaccination program in 2009 following the H1N1 flu season, Dionne-Odom said its rates have skyrocketed to more than 90 percent.

As New Hampshire continues to see widespread flu cases and Boston is grappling with a public health emergency and staging emergency flu clinics, the issue of whether states like New Hampshire should vaccinate all of its school children is up for debate. Pamboukes and Dionne-Odom agree that schools have always been a fertile breeding ground for flu viruses to spread among school children in the classroom, then to their parents at home and the rest of the community.

Dionne-Odom said the New Hampshire Immunization program is currently conducting a two-year pilot program where it invites communities and school districts to hold flu clinics each year. She said some communities like Portsmouth choose to do flu clinics, but others don't because they lack sufficient facilities and/or the personnel to hold them. She said some of New Hampshire's six public health network regions are better equipped then others to hold flu clinics.

In some cases, Dionne-Odom said school districts have declined because they say most of their students and their parents are obtaining flu vaccinations at area pharmacies or at their health care providers.

Pamboukes said Portsmouth continues to explore ways to offer flu vaccinations to more people beyond the students and staff in the Portsmouth Schools. For example, she said the district held a community flu vaccination clinic at Portsmouth High School for students and staff at all five Portsmouth schools and parents who live in the communities of Portsmouth, Rye, and Greenland on Oct. 17.

Surprisingly, Pamboukes said not as many students and staff or community members took advantage of the flu vaccination clinic as she had hoped.

"Our numbers were down this year. We had 300 individuals," she said. She attributes that to "complacency."

When asked if New Hampshire may ever implement a school vaccination clinic model like Maine, Dionne-Odom said state health officials will continue to look at the data they are compiling from the current pilot and assess it.

"I don't think there is a one size fits all answer here in the state, unfortunately," Dionne-Odom said. "Mandates in New Hampshire are not very popular."