New Jersey will be the first U.S. state to require children to get annual flu shots to attend licensed day-care centers or preschools.

Health Commissioner Fred Jacobs approved Friday new immunization rules mandating four additional shots as of September. The requirements will reduce childhood illnesses, Eddy Bresnitz, the state epidemiologist, said in an interview.

"We will be the first state in the nation requiring this," Bresnitz said. "The benefits far outweigh the risk."

The approval was given over the opposition of parents and other critics who said the policy intrudes on parental rights and the vaccinations have health concerns, including a possible link to autism, a developmental disorder. Bresnitz said there is no scientific evidence of such a link.

Jacobs' approval followed Monday's vote by the state's Public Health Council that recommended the new shots. The rules require annual influenza vaccinations and a pneumonia vaccine for children in child-care centers and preschools.