Since our children returned to school after winter break, we have collectively had weeks of viral illnesses run through our households. As physicians in both primary care and specialty settings, we are seeing the same pattern play out in many families. Schools are wonderful places for children to learn and grow academically and socially, but they are also efficient environments for spreading infectious diseases.
This is where school vaccination requirements are needed. By requiring students in public schools to be vaccinated against the most dangerous and contagious infectious diseases, we protect not only individual children but entire communities. These requirements help ensure that the germs circulating in classrooms are, more often than not, โjustโ common colds.
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Vaccination requirements support what is known as herd immunity. This refers to the level of immunization needed in a population to protect those who cannot be vaccinated, such as newborns or children undergoing cancer treatment. When vaccination rates are high, dangerous diseases are far less likely to spread.
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Granite Staters pride themselves on being good neighbors. Immunizing our children is another way we look out for one another, especially for the most vulnerable among us.
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That shared responsibility is now under threat. Two bills introduced this legislative session would undermine school vaccine requirements. House Bill 1719 seeks to remove hepatitis B from the list of required school immunizations, while House Bill 1811 would eliminate vaccine requirements altogether.
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At the hearing on HB 1719, a committee member asked, โWhat has changed about hepatitis B or the vaccine that caused the CDC to change guidance it has had for the past 35 years?โ The answer is simple: nothing.
Hepatitis B remains a highly contagious and potentially deadly disease, and the vaccine continues to be safe and effective, with minimal side effects. The introduction of the hepatitis B vaccine in the United States led to a dramatic drop in rates, by 77%, in children less than 5 years old. Along with the drop in hepatitis B infections, we have also seen a drop in incidence of liver cancer caused by hepatitis B. As clinicians, we do not want to return to a time when these preventable outcomes were common.
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Some people ask, โWhy not just make vaccines available and let parents choose?โ On the surface, that seems perfectly sensible. After all, the vast majority of parents intend to vaccinate their children. But the reality of raising kids is far more complicated. Parenting is relentless and often overwhelming. Families face a constant stream of decisions, competing demands, and contradictory information, making it genuinely difficult to know what deserves attention first.
In the real world of sports schedules, school and work responsibilities, and navigating child care, making extra appointments can be challenging. And, more realistically, may not be a priority or fall lower in the never-ending list of priorities, if itโs not a requirement that is needed. School requirements help families by making the safest choice the default choice. Study after study shows that schools with stronger vaccine requirements have higher vaccination rates and stronger community protection as a result.
Online misinformation has made vaccine decision-making far more difficult for families. Social media and online forums often amplify misleading or incomplete information, presenting it as equivalent to decades of rigorous scientific evidence. As physicians, we routinely spend limited visit time correcting false claims that spread far faster than facts.
In addition, citing vaccine schedules from other countries such as Denmark without context is misleading. Vaccine schedules are designed around each countryโs disease prevalence, health system structure and population risks. The U.S. schedule reflects the realities of disease exposure, health care access, and the need to protect children early, and it is not interchangeable with schedules developed for countries with different epidemiology and public health infrastructure.
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Eliminating vaccine requirements would also have real cost consequences. When vaccines are no longer required, insurance coverage often becomes less consistent and out-of-pocket costs will rise. Families with financial means may still be able to vaccinate their children, but those living paycheck to paycheck may be forced to delay or forgo vaccines altogether regardless of their desire to protect their children. In primary care, we see this reality every day: when preventive care is no longer universally covered or prioritized, access becomes uneven, and children from lower-income families bear the greatest risk.
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Governor Kelly Ayotte has remained consistent in her approach to vaccine-related legislation, emphasizing that these decisions should be guided by medical experts, not politics. Last session, she vetoed a bill that would have weakened school immunization requirements, noting plainly that โchildhood immunizations play an important role in preventing the resurgence and spread of previously deadly diseases.โ
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Public schools must be safe for everyone: for the child with a newborn sibling at home, for the child with juvenile arthritis on immunosuppressive medication, and for the many families who want to vaccinate their children but rely on clear public health guidance.
The science is clear, and most parents agree. School vaccine requirements ensure that our childrenโs health, and our shared responsibility to one another, is not left up to chance.
Christine Arsnow, MD, is the president of the American Academy of Pediatrics New Hampshire Chapter. Health care workers Douglas Phelan, Frances Lim-Liberty, Maria Boylan and Pamela DiNapoli contributed to this My Turn.