In the Far Rockaway neighborhood of Queens, Emmanuel Green picks up his 4-year old daughter, Emily, from Far Rockaway Child Care Center on most days. Green, who has a faded dollar sign tattooed under his eye, carries her small pink backpack as they walk home together. He has been coming to this center for many years. His 11-year old son also attended. And he’s had no complaints—until recently.
A change in city law last June now requires children attending city-regulated child care or school-based programs to get annual flu shots. Some centers, though, are finding it difficult to comply with the new law because they face strong resistance from parents, like Green, who disapprove of their children getting the vaccine.
As a result, many child care centers across the city have accumulated serious health violations—there are 353 open violations, some dating back to November, related to the immunizations for influenza, among other diseases, at New York City child care centers, according to the New York City Department of Health and Mental Hygiene child care inspection data. Last year, from November to April 2018, there were only 109 immunization violations recorded.
The rise in immunization violations in New York City child care centers possibly reflects a global trend of skepticism towards vaccines and the belief among many parents that vaccines cause health problems. Vaccine hesitancy has reached such critical levels that the World Health Organization listed it as one of the top ten threats to global health in 2019—a threat that has already had a direct impact on residents of New York City. Measles, for example, has been on the rise—and many connect it directly to the resistance towards immunization. Since October of last year when the first case was detected, 214 people have contracted measles, mostly within the Orthodox Jewish community in Brooklyn, according to the Department of Health. Another measles outbreak in Rockland County, New York became so dire last month that a declaration was issued banning unvaccinated children under 18 years old from public places for 30 days.
The most common immunization violation at child care centers in New York City though relates to the flu vaccine—for failing to ensure that enrolled children six months to 59 months have received the immunization. One child care center in the Queens neighborhood of St. Albans, Montessori Progressive Learning Center, had 38 violations for the flu vaccine as of early April.
“I’ve never seen anything like this from parents before,” said Kesha Gray, a staff member at Montessori Progressive Learning Center, regarding the pushback that the center is facing.
Gray, the staff member at Montessori Progressive Learning Center, said that many students have never been vaccinated for the flu before, and that most of the parents of the 38 students brought in letters refusing the vaccine. The Department of Health did not accept their letters though, she said, claiming they were not, “heartfelt enough.” The law includes a provision where certain children can be exempt for religious reasons.
Some parents are refusing the vaccination on religious grounds, but not all of them, said Gray. Montessori Progressive Learning Center has children from diverse backgrounds—African American, Hispanic, Middle Eastern, and South Asian, among others. She said though that parents have a right to do what they feel is best for their child. “We are kind of the middle person, and you feel like your hands are tied.”
Immunization violations are categorized by the Department of Health as a critical violation, which is deemed serious and must be corrected within two weeks. Every serious health violation is reviewed by a judge at a hearing who decides what penalty, if any, to issue. According to the city’s health department, penalties can be fines of up to $2,000, and, in certain cases, can lead to a permit suspension.
There were 6,696 laboratory-confirmed influenza reports in New York State, and 1,062 patients hospitalized with laboratory-confirmed influenza during the week ending March 23, according to the Department of Health. This season, there have been five influenza-associated pediatric deaths reported in the state of New York. The Department of Health warned that the illness is widespread.
Regardless, many parents are frightened by immunizations. “It’s all over Facebook, people getting sick from the vaccine. You see it. It’s not a lie,” said Lisa Angie, whose 4-year old daughter attends Montessori Progressive Learning Center. Angie said her husband practices Rastafarian and that they prefer to use herbal products.
Another parent, Stacy Bell, whose daughter Bella Bell attends Montessori Progressive Learning Center as well, is also skeptical about the vaccine. “If she has a cold, it is only going to make it worse.” She said she personally has never had the flu vaccine, and has not had any issues.
Another child care center in Jackson Heights neighborhood of Queens, 82nd Street Academics, had 19 open violations for failing to have proper documentation of immunizations of enrolled children, according to data from March.
Mallory Tompkins, the director of instruction and learning, said that one of the reasons for the lack of immunized students is that many parents had trouble getting appointments with pediatricians to get the vaccine for their children. To assist the families, the school provided an on-site clinic where they provided the influenza vaccine in February. As of early April, the center no longer has open immunization violations.
City-regulated child care centers are having to take more severe measures to ensure children at their centers are immunized. If parents cannot provide documentation that their child received the influenza vaccine by December 31, schools are allowed to exclude them from child care. Michael Lanza, from the Department of Health, said though, there is often a learning curve with new mandates. “We are confident that child care programs will improve compliance over time.”
Far Rockaway Child Care Center, where Green sends his 4-year old daughter, Emily, had eight immunization violations as of April 1. Despite his strong disapproval of the flu vaccine, Green, like many parents, caved eventually, and had her immunized. “I had to get it,” he said. “Or Emily would not be allowed to go to school.”