NORTH ADAMS — Massachusetts' new flu vaccine mandate has garnered praise from national health experts, but it has led to questions within the state over how it will play out.
Caught off guard by the recent announcement, some state lawmakers, who say they support increasing vaccination rates, have expressed concern over the mandate's communication and uncertainty over its implementation. With their inboxes flooded by constituents' messages, they say they have fielded more questions than they can answer.
"I heard about it from the media," said state Sen. Anne Gobi, D-Spencer. "That's kind of frustrating, because when it comes out, people aren't necessarily sending a letter to the secretary of Health and Human Services. They're contacting their local representatives and senators. And it puts us in a bit of a bad position when we don't know what's going on."
In an email to Gobi, one constituent, a self-described "very upset mother of 4," asked, "How can a governor think he gets to decide what is best for other people[']s children?"
Gobi, in an email to Secretary of Health and Human Services Marylou Sudders, relayed some questions from constituents. Gobi noted that legislators did not receive advance notice, despite having had a legislative call with Sudders on Tuesday.
"Unfortunately, the timing of the scheduled legislative call and the release of the announcements precluded an ability to say anything in advance of the Governor's press availability on [Aug. 20]," Sudders replied, adding that the Department of Public Health made the initial recommendation for the mandate.
Under the mandate, announced Aug. 19 by the DPH, students across all levels of schooling in Massachusetts now will be required to receive flu vaccines, a new mandate that state public health officials described as a step to reduce the impact of flu-related and respiratory illnesses during the COVID-19 pandemic.
The immunizations will be required from the age of 6 months on for attendees of Massachusetts child care programs, preschools, K-12 schools, and colleges and universities, and will remain in effect beyond the pandemic.
Regarding cost, Sudders said 97 percent of Massachusetts adults and 98.5 percent of children younger than 18 have health insurance, and that health insurance must cover flu shots under the Affordable Care Act, with no copayment. The state's Health Safety Net provides low-income patients with flu shots at no cost, she added.
Gobi said that after the mandate announcement, she contacted a pediatrician who also was surprised at the announcement.
"They're in a small office, and they're concerned about being overrun with parents wanting to come in," Gobi said. "When you come out with a policy that's going to affect so many people, and not to even let the medical profession know, I don't think that's a really great way to do things."
Some Berkshire lawmakers also expressed concern over communication.
"The governor made this announcement ... without any warning, without any consultation," said state Rep. Tricia Farley-Bouvier, D-Pittsfield. In a Facebook post, she added that the lack of prior notice "has been the norm from the governor on pretty much everything since March."
state Rep. Paul Mark, D-Peru, expressed displeasure about the rollout.
"I have received almost no guidance from DPH on the flu vaccine mandate, and that includes no heads-up before the announcement and no request for thoughts or feedback before they made their decision," he said.
Berkshire pediatricians' offices say they expect that they can handle increased demand. While pharmacies like CVS and Walgreens offer flu shots for individuals 9 and older, younger children have fewer options.
Northern Berkshire Pediatrics already had ordered more tests than normal, in addition to setting up more spaces and times for flu shots to enhance safety, said practice manager Don LeBreux.
"With COVID going on, we were already ramping up to try to vaccinate as many people as possible," he said.
The DPH has told Community Health Programs "that adequate supply is being produced and that they will aid in backing up demand," said CEO Lia Spiliotes.
Vaccine manufacturers have upped production nearly 15 percent, to almost 200 million doses nationally, amid worries that flu season could further hamper health care systems already stretched by COVID-19. The U.S. Department of Health and Human Services also has said it would authorize pharmacies to vaccinate children ages 3 through 18.
Sudders told Gobi that the DPH will make 1,156,000 doses available to providers free of charge, a 28 percent increase from the previous year.
With the predicted increase in student demand, it's important to ensure that other groups have access to the vaccine, Gobi said.
"One thing that is concerning to me is that, in years past, we haven't had enough of the flu vaccine," she said. "So, now you have very vulnerable populations — people who are elderly or with preconditions that would give them priority. How are they going to get the vaccine if we're going to put kids first in line?"
The mandate's enforcement, which the DPH said will be "determined at the local level," remains unclear as well. The requirement does not apply to staff or teachers.
Farley-Bouvier said that while she wants as many people as possible to get the vaccine, she believes the mandate "is only adding to the confusion" faced by parents weighing their options for schooling.
"My humble opinion is that we would have better accomplished the goal of very high rates of flu vaccinations with an effective communication/education plan and highly accessible vaccination clinics," she wrote on Facebook.
Early education providers also have received little guidance, said Tracy Sheerin, director of KidZone in Pittsfield.
There is a fear that parents' failure to comply with the mandate would lead to declines in enrollment at child care centers, which Sheerin said already are struggling to stay open.
"The way they announce it to the public, our phones ring off the hook with questions because the communication is not great," Sheerin said. "If it's not for the news, we wouldn't even know."
Information from State House News Service is included in this report.
Danny Jin, a Report for America corps member, is The Eagle's Statehouse news reporter. He can be reached at firstname.lastname@example.org, @djinreports on Twitter and 413-496-6221.