MONTPELIER, Vermont (NewsNation) — Vermont is considering becoming the second state to mandate flu shots as a way to ease the burden of influenza amid the coronavirus pandemic, public health officials said.

Vermont Health Commissioner Mark Levine said Friday the rate of flu in the state needs to be as low as possible to avoid a situation he called a “twindemic.”

Levine wrote in an email that 43% of Vermont children age 5 to 12 received a flue shot last year, NewsNation affiliate WVNY reported. Meanwhile, 36% of teens under age 18 had recevied one, Levine said.

“Our primary focus will be to increase the rate of vaccination, especially among children and teens,” Levine said. “We can and must do better.”

Levine said a decision has not been reached about whether to require universal flu vaccines for all students.

Massachusetts authorities recently made a move to require flu shots for school. Officials in the state also cited the need to avoid overburdening the health system with both diseases.

Levine said the decision about whether to require flu shots will be “driven, as always, by data and science.”

The Associated Press and NewsNation affiliate WVNY contributed to this report.