Hanan Bedri, MS, MA, is the executive director of New Hampshire Public Health Association. Marie Ramas, MD, is a NH Medical Society council member and president of the NH Academy of Family Physicians.

State legislators will soon vote on HB 557, which removes the authority of the DHHS Commissioner to determine immunization requirements for school and childcare attendance.

In other words, the body that currently decides what new vaccines will be required in schools and childcare will no longer have that authority. The bill goes further, to mandate that while the health department will continue to require diphtheria, mumps, pertussis, poliomyelitis, rubella, rubeola, and tetanus vaccinations, after June of 2026, it will no longer require public school students to be protected from Hepatitis B, Haemophilus influenzae type B (Hib), and varicella, a.k.a. chickenpox.

Varicella is a highly contagious illness. Once someone is infected, 60 to 100 percent of susceptible people in their household will catch it. It causes fevers and rashes, and while most children face mild infections, adults and kids with compromised immune systems can suffer tremendously, with problems ranging from pneumonia to meningitis and encephalitis.

Varicella can lie dormant in a body and reactivate later in life, causing painful skin conditions and, in rare cases, comas, seizures, strokes, and deaths. After vaccines were required to enter schools, varicella deaths dropped about 94 percent, and the vaccine is 90 percent effective at preventing later infections. It is a public health success story, an intervention into our immune systems that has inarguably borne fruit.

Hepatitis B, another notable disease, can cause nausea, cirrhosis, liver cancer, and death. It can be spread through sexual contact, sharing needles, and sharing toothbrushes. Hib, a bacterial infection, spreads even more easily, and was, until recently, one of the most common causes of bacterial infection in young children. Few cases of Hib infection have been diagnosed since the vaccine was implemented as a requirement for entry into childcare and public schools.

The danger these illnesses pose is not restricted to the children who currently must be protected against them, if they are to enter our school system. If one unvaccinated child catches one of these illnesses, they can spread it to their parents, grandparents, and friends outside of school. If someone with compromised immunity catches it, consequences can be long-term, if not fatal.

Health legislation aims to protect and promote the health of the community. HB 557 does not state the health problem it intends to resolve, nor does it specify that there is one; nor does it indicate a precise means by which to test its proposed “correct” approach (and consequences) of removing health experts from overseeing immunization requirements in New Hampshire.

Health experts provide that oversight through the Department of Health and Human Services. Anytime the DHHS makes the rare move of considering whether to add a new vaccine as a requirement for school or childcare attendance, an extensive and thorough review process ensues.

DHHS representatives meet with doctors and scientists who specialize in the prevention of infectious diseases. Every pertinent factor is considered, from how the disease in question is transmitted to the presence of populations in the state who are especially vulnerable to it. The DHHS must review feedback from the public, and seek legislative concurrence through the Joint Legislative Committee on Administrative Rules (JLCAR). In other words, our state legislature has a say in what vaccines our children require if they are to enter schools and be in contact with many other children.

DHHS also has an Ethics Oversight Advisory Committee, which includes members of the House and Senate, and a diverse group of stakeholders. Should the commissioner consider changes to the list of required vaccinations, the Ethics Oversight Advisory Committee would convene to review any recommendations related to vaccination requirements for school and childcare attendance.

The department’s current system protects the public’s health and provides a balanced choice for parents and individuals; it allows for legislative and public input to protect the health of all children. And it is rare for a new vaccine to be required in our schools. The most recent addition was the varicella vaccine, instated in 2003, eight years after its approval by the Food and Drug Administration (FDA).

It is worth mentioning, since it recently posed a unique challenge to our public health system, that DHHS does not intend to require the COVID-19 vaccine for attendance in schools or childcare as was noted at the HB 557 hearing in February. The same goes for the influenza vaccine."

HB 557 is not only unnecessary, but it also threatens to erode the tried and true system that has kept ourselves, our friends, and our neighbors mostly free from worry about catching things like meningitis when we go to the grocery store. It seeks to partially dismantle a system without providing a rationale for that move, and without offering replacement parts for those it will toss out. We must not compromise our health and the health of those around us.

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