CONCORD – At a time when childhood immunization rates are declining nationally and Texas is experiencing a serious measles outbreak, the House Health, Human Services and Elderly Affairs Committee heard testimony Wednesday on two vaccine bills.
House Bill 357 would take away the state Health and Human Services Commissioner’s power to make rules that add new vaccines to the state schedule of required childhood vaccinations and would delegate the power to authorize new vaccines to the legislature instead.
The bill also would allow three vaccination requirements on the current schedule to expire on June 30, 2026: chickenpox, Hepatitis B and Haemophilus influenzae type B (Hib), a type of flu that is more serious in children under 5 and can lead to complications including pneumonia and meningitis.
If the bill passes, New Hampshire would be the only state not to require the chickenpox vaccine.
The committee also heard a related proposal, House Bill 358, that would make it easier for parents to obtain religious exemptions from vaccinations for their children.
The state has a list of vaccinations that children must get to attend schools and day care centers, but the system allows for both medical and religious exemptions. About 3 percent of children in the state have these exemptions, up from 2 percent in 2022. The forms acknowledging the exemption identify the children so they can be removed in case of an outbreak.
Rep. James Kofalt, R-Wilton, sponsor of both bills and a member of the committee, said HB 357 would look familiar to those who served during the 2024 session. The main difference in this session’s version is that it removes rule-making authority from the commissioner.
The bill would keep the current schedule of required vaccines for now. In addition to the three vaccination requirements that would expire in mid-2026, the rules also require children to be vaccinated against diphtheria, mumps, pertussis, polio, rubella, rubeola and tetanus.
State health officials objected to both bills and said keeping the vaccination list in rulemaking allows for the state to be more “nimble” in an outbreak than having the legislature convene for emergency action.
The state has a concern for the health of all people and an important role in setting immunization requirements to protect vulnerable people in congregate settings, said Dr. Benjamin Chan, state epidemiologist.
The state has not added a new vaccine since 2003, and is not currently proposing any new ones, Chan said.
“We have no plans to make the COVID-19 vaccine a required vaccine” to attend school, he said. Kofalt said that decisions about vaccine requirements should only be made by elected representatives.
“When we mandate any type of medical intervention, that is a very serious matter,” he said.
He said COVID-19 vaccines and their efficacy will be debated. He also said he is skeptical of some vaccines being administered to infants for adult diseases.
“This is a choice that should be made by parents and not mandated under rule,” he said. “If we do mandate it, it should be done by those elected.”
But others said individual choice can sometimes put public health at risk.
Colleen Smith, bureau chief for the Bureau of Infectious Diseases at DHHS and Dr. Chan spoke together in opposition to the bill.
Smith said the department believes in a rigorous procedure for adding any vaccination and the state has a conservative list compared to other states. The department’s rulemaking authority allows it to respond quickly to an outbreak and thereby limit people’s exposure, and putting the legislature in charge could add months to the process, she said.
A number of speakers at the hearing talked about a measles outbreak in West Texas in which one child has died and more than 100 are ill. Chan noted that 13 percent of the children in Texas have been hospitalized with measles and said that such serious disease outbreaks are preventable through vaccination.
He said the department appreciates a healthy discussion because there are concerns for protecting both individuals and people in congregate settings where infectious diseases can spread easily.
He said the department’s primary concerns are the removal of rulemaking authority and the elimination of the chickenpox vaccine requirement.
The administrative rules also vary by age and vaccine dosage, and none of that is captured in the law, Chan said.
Supporting the bill was Laura Condon, director of advocacy for the National Vaccine Information Center. She said this is not about vaccine mandates but about who makes the decision on vaccines: the “public or the very closed process of rulemaking.”
She said 15-month old New Hampshire child Ryan Johnson died after receiving five routine vaccinations. “Measles are not killing healthy children,” she said, arguing those children have underlying health risks.
Dr. Christine Arsnow, a Concord pediatrician, said the bill is nationally alarming to pediatricians and it would remove flexibility.
It “threatens the health and safety of New Hampshire children,” she said. “I believe the public health experts … are more appropriate to be making decisions about public health.”
Melissa Blasek, a former Republican state representative from Merrimack, said she supported the bill for taking away authority from “bureaucrats” and giving it to elected leaders. Some may argue elected officials are not health experts, but she said they do consider what they hear from others.
She said the bill is about restoring freedoms and rights.
Pam Dinapoli of the New Hampshire Nurses Association and the New Hampshire School Nurses Association opposed the bill and offered her personal concerns for the public’s health if it passed.
Vaccines have been safe and reliable and protect people of all ages, she said.
She said the part of the bill eliminating vaccinations also could be considered an economic measure, because parents would miss work to care for their children.
CHANGE IN RELIGIOUS EXEMPTIONS FOR VACCINES
House Bill 358 provides that a parent or legal guardian may claim an exemption from childhood immunization requirements on the basis of religious belief by providing a signed statement to that effect. The bill removes the statutory reference to a “form” used for that purpose.
Kofalt said the bill is aimed at correcting an unanticipated problem that came up following a change in the religious exemption clause several years ago.
The law referenced a form that would need to be notarized, but Kofalt said the state had no form at the time. It developed one that has parents initial three different warnings, including that in the event of an outbreak, their unvaccinated child would be excluded from school or day care.
The bill simply removes any reference to the need for any form, he said.
Smith and Chan expressed concern, noting the bill would take away a standardized way for schools and child care centers to collect the information and know which vaccinations had not been administered.
Smith said that information would be crucial in an outbreak.
The number of people who signed up online to support or oppose the bills was lopsided, with most opposing them.
Just before the hearings, 124 supported HB 357 and 633 opposed it, while 113 supported HB 358 and 767 opposed it.
A link to House Bill 357 is here https://gc.nh.gov/bill_status/billinfo.aspx?id=444&inflect=2
A link to House Bill 358 is here https://gc.nh.gov/bill_status/billinfo.aspx?id=448&inflect=2