In group care, children not only share toys, they share germs. But immunization and hygiene are effective ways to control infectious disease. Most kids are fully immunized by the time they enter kindergarten because state laws require it. Overall, kids in child care are better immunized than the population as a whole, because most states expect some documentation of immunization for children in regulated child care. Such rules encourage more parents to vaccinate their children on time - when they are babies, instead of putting it off until they go to regular school.
Immunization is very effective, but so is hygiene.
Caregivers and children should wash their hands before eating, after diaper changing or using the toilet, after wiping runny noses, or playing outside. Research shows that when hand washing is combined with routine cleaning and disinfecting of frequently touched surfaces, kids get sick less often. Children in child care get fewer colds and ear infections, and less diarrhea when child care providers practice good hygiene routines. We also can avoid harm by preventing injuries in child care. The largest number of severe injuries in child care occur when children fall from climbing equipment mounted over hard surfaces - either indoors or outdoors.