By RICH DiPENTIMA

In a recent article State Representative Jim Kofalt defended HB 1811 which would eliminate state vaccine mandates for school and daycare attendance, well, sort of.  In his argument against vaccine mandates Rep. Kofalt made two points to support the bill; one philosophical and one a comparison of America to other nations.

With regard to the philosophical argument, HB 1811 as amended states that, “Every person has a natural. essential, and inherent right to bodily integrity, free from any threat or compulsion by government to accept an immunization.  Accordingly, no person may be compelled to receive an immunization in order to secure or access any public facility, any public benefit, or any public service from the State of New Hampshire, or any political subdivision thereof, including but not limited to countries, cities, towns, precents, water districts, school districts, school administrative units, or quasi public entities.”

In a serious inconsistency, HB 1811 removes all vaccine mandates with the exception of polio.  As such, the bill still mandates a polio immunization to enter school or daycare, putting them in violation of their own bill, which as stated above reads, “no person may be compelled to receive an immunization.”   If you can mandate polio, then you can mandate other immunizations.

What is the public health or philosophical justification to retain a polio immunization mandate while discarding all other diseases that also pose significant threats to children?  Why would volunteer immunization for all other diseases be acceptable, but for polio “coercion” would still be necessary?

A government mandate for  polio immunization is no different than a mandate for any other vaccine, but it makes less public health sense than having mandates for the other diseases.  While polio is a very serious disease and an immunization mandate is appropriate, polio is not as transmissible person-to-person as other diseases that have been removed from the mandate list.  Polio is mostly transmitted person-to-person via the fecal oral route, and rarely by respiratory droplets. 

However diseases like measles, rubella, chickenpox, diphtheria, pertussis and meningitis, which would no longer be required, are highly transmissible person-to-person through respiratory droplets and through airborne transmission, making them much more dangerous than polio in a classroom or daycare setting. In fact, the nation is currently experiencing large outbreaks of measles, and have also had recent outbreaks of pertussis, meningitis and other diseases that would be eliminated from the immunization mandate requirement in HB 1811. 

His second argument compares America to  nations like Sweden and Denmark, which do not have vaccine mandates but still maintain very high immunization rates.  That is true. However Rep. Kofalt fails to mention a number of significant differences between America and those nations.  First, both Sweden and Denmark have universal national health care systems.  Second, these countries are very homogeneous with very little ethnic or racial diversity, very low poverty rates and populations much smaller than the United States. If Rep. Kofalt wishes to compare us with these nations and follow their health and vaccine policies, why stop there? He should also support a universal health care system in America as well.

Childhood vaccine mandates have served New Hampshire well for many years.  Vaccines have proven to be extremely safe and effective in preventing disease and keeping our children safe from the scourges that impacted humans for millennia.  New Hampshire has a very high immunization rate and has been fortunate to have prevented many disease outbreaks like those currently seriously impacting  other states.  Removing these mandates will only result in lowering immunization rates and setting the stage for more disease, education disruption, economic impacts and most importantly putting our children at greater risk.  This is a ideological social experiment that we need not expose our children to.

Hon. Rich DiPentima, RN, MPH
Portsmouth, NH 03801

Former Asst. Director NH Division of Public Health Services, Deputy Public Health Director Manchester health Dept., Retired Air Force Public Health Officer and former State Representative.