Modifies the authority for pharmacists and pharmacy interns to administer vaccinations by including vaccines listed in the recommended adult immunization schedule by the Centers for Disease Control and Prevention, rather than listing out specific vaccines by name.
Vaccines required by NH state law
New Hampshire law requires any child enrolled in public school, private school, or child care to get vaccinated against the following diseases:
Vaccines required by DHHS rules – and why that’s controversial
State law allows the Department of Health and Human Services (DHHS) to require other vaccinations through a rulemaking process outside the legislature. DHHS can add or subtract from this list without any changes to state law.
Some argue that it is inappropriate to give bureaucrats the power to require certain vaccines without democratic input through the legislature. On the other hand, the current system gives health experts the ability to respond quickly to disease outbreaks.
Right now DHHS requires vaccines for the following diseases:
- Hepatitis B
- Varicella (chickenpox)
- Haemophilus influenza Type b (leads to bacterial meningitis)
The debate over the hepatitis B vaccine requirement
State law forbids DHHS from requiring a vaccine for any disease “that is not infectious or transmissible from person-to-person.” Some opponents argue that hepatitis B is so rare among children that it is inappropriate to require that vaccine.
Financial aid for meeting state vaccination recommendations
If a family cannot afford a recommended childhood vaccine, the state will pay for it through the Immunization Program. That program is funded through a combination of federal grants, health insurer contributions, and the state general fund of tax dollars.
Exemptions from vaccine requirements
New Hampshire law allows an exemption from vaccine requirements for medical or religious reasons.
New Hampshire does not allow parents to reject childhood vaccinations just because the parent believes vaccines are harmful.
In the event of a disease outbreak, children exempted from vaccine requirements may not attend school.
Vaccine requirements for adults
New Hampshire state law does not require adults to get vaccinated. However, employers – particularly in the health care field – may require vaccinations as a condition of employment. Colleges may also require students to get vaccinated.
Some states, such as Oregon, have passed laws that forbid employers from requiring that workers get vaccinated.
Immunization Information System
Health care providers in New Hampshire will be required to report a record of every vaccination they administer to the state Immunization Information System (IIS) - once it is up and running. The creation of the system was approved in 2016, but has been plagued by delays.
Once active, the IIS could be used to track immunization records and identify unvaccinated people in the event of a disease outbreak. Health providers will be able to make changes to the IIS. Schools, licensed child care agencies, and public health offices in Manchester and Nashua will have limited access to read records in the IIS.
Health providers must give patients the opportunity to opt-out of the IIS.
Vaccines at pharmacies
In New Hampshire, pharmacists may administer flu, pneumonia, chickenpox, hepatitis A, hepatitis B, Tdap (tetanus, diphtheria, pertussis), MMR (measles, mumps, rubella), and meningitis vaccines to adults. Pharmacists must complete certain training to administer vaccines.
Almost all other states allow pharmacists to administer these vaccines. However, some opponents argue that vaccines should only be administered by an individual’s primary health care provider, who has complete information about a patient’s medical history and is more aware of possible adverse reactions.
PROS & CONS
“NH should maintain current vaccine requirements.”
- If the New Hampshire Legislature takes over the list of required vaccines, the Department of Health and Human Services (DHHS) will not be able to respond as quickly and effectively to a disease outbreak.
- The DHHS rulemaking process for adding vaccine requirements includes an opportunity for public comment, just like the public hearings in the legislature.
- National and international organizations, from DHHS to the World Health Organization, all agree the vaccines required in New Hampshire are safe and recommended for all children. According to the Centers for Disease Control, there is no evidence linking vaccines and autism. On the other hand, as more parents have chosen to opt-out of vaccinations, there have been more outbreaks of vaccine-preventable diseases.
- Private employers should have the liberty to require vaccinations as a matter of workplace safety – particularly in health care settings. If an employee does not want to get a vaccination, the employee can always negotiate with the employer or find a new job.
- Vaccinating children saves on health costs in the long-term, since those children do not become sick with vaccine-preventable diseases as adults. According to the International Vaccine Access Center at Johns Hopkins, increasing the number of children vaccinated against hepatitis B could save billions of dollars in lost productivity and treatment costs.
“NH should change current vaccine requirements.”
- Many states allow parents to opt out of vaccine requirements for any personal belief, not just for religious or medical reasons.
- Since vaccines impact individual health, the public deserves more of a say over vaccine requirements than other state rules. The Department of Health and Human Services (DHHS) should not be able to add vaccine requirements without the approval of the New Hampshire Legislature, because the rules process in DHHS does not provide as many opportunities for public input as the legislative process.
- Requiring the hepatitis B vaccine, in particular, is an unjustified requirement for children. Hepatitis B is far more common among adults than among children, often spread through sexual contact or illegal IV drug use.
- People should not have to choose between making a living and controlling their own health care. New Hampshire should therefore prevent employers from requiring employees to get vaccinations.
Removes tetanus from the list of legally required child vaccinations.
Adds a defintion of "vaccination" and "vaccine" to the law relating to communicable disease.
Allows a pharmacy intern under the supervision of a pharmacist to administer hepatitis A, hepatitis B, Tdap, MMR, and meningococcal vaccines.
Establishes requirements for dispensing and substituting biological products by pharmacists. The bill defines biological products as, "a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component or derivative, allergenic product, protein (except any chemically synthesized polypeptide), or analogous product, or arsphenamine or derivative of arsphenamine (or any other trivalent organic arsenic compound), applicable to the prevention, treatment, or cure of a disease or condition of human beings."
Declares that a parent or legal guardian shall not be required to have their child immunized against hepatitis B or other sexually transmitted diseases.
Limits the court's authority to order that a child be vaccinated over the objection of one of the parents.
Prohibits the state from setting any vaccine requirement "for diseases that are noncommunicable in a child care or school setting, including, but not limited to, hepatitis B." Right now the Department of Health and Human Services requires all school children to be vaccinated against hepatitis B. The House amended the bill to instead forbid an immunization/vaccination requirement for diseases that are noncommunicable.
Allows a pharmacy intern to administer vaccines under the direct supervision of a pharmacists.
Would only allow the state to require vaccines for diphtheria, mumps, whooping cough, polio, rubella, measles, and tetanus. Right now the Department of Health and Human Services is allowed to add other vaccine requirements, and currently requires vaccines for hepatitis B and chickenpox.
Requires licensed pharmacies to establish continuous quality improvement programs. The bill was amended to also allow pharmacists to administer hepatitis A, hepatitis B, Tdap, MMR, and meningococcal vaccines. Lastly, the bill was amended to give the Insurance Department more power and flexibility to regulate health insurance costs during federal health care reform.
Allows pharmacists to administer hepatitis A, hepatitis B, Tdap, MMR, and meningitis vaccines.
Adds the MMR vaccine to the law which allows licensed pharmacists to administer vaccines. This bill was originally written to also allow pharmacists to administer hepititis, meningitis, and other vaccines.
Forbids employers from requiring employees to receive vaccinations.
Clarifies certain options relating to the immunization/vaccination registry, including the ability to opt-out, and exempts the registry from the right-to-know law.
Establishes an opt out option for participation in the immunization registry.
Should NH maintain current vaccine requirements?
DHHS plans to seek new bids to create a statewide vaccine registry system. After years of delays, a contract with a previous vendor expired on January 31st with the registry still unbuilt.
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