Vermont may become just the second U.S. state to mandate flu shots for school-age children. The idea is currently on the table, according to Health Commissioner Dr. Mark Levine.

In an email, Dr. Levine wrote that Vermont’s rate of flu infections needs to be kept as low as possible — particularly among young people — to avoid having to fight outbreaks of influenza and COVID-19 at the same time. Levine added that 43% of Vermont children ages five through 12 got a flu shot last year, while 36% of 13-to-17-year-olds had one.

Massachusetts is the only state that requires all K-12 students to get vaccinated against the flu each year.