New Jersey ? New Jersey on Friday became the first state to require flu shots for preschoolers, saying their developing immune systems and likelihood of spreading germs make them as vulnerable to complications as the elderly.

State Health Commissioner Dr. Fred M. Jacobs approved the requirement and three other vaccines over the objections of some parent groups.

Starting in September, all children attending preschool or licensed day care centers will have to get an annual flu shot, Jacobs said.