N.H. to create vaccine database

Monitor staff
Published: 12/18/2019 10:07:22 PM

The Executive Council voted Wednesday to accept $1.5 million in federal money to create a vaccination database, after state officials failed to fully implement an earlier system.

In a 5-0 vote, councilors opted to accept the grant from the Centers for Disease Control and Prevention to create an “immunization information system” in the Granite State.

The system would collect a record of every immunization dose administered through participating providers, and aggregate the data to help guide “public health action to improve vaccination rates,” according to a document from the state’s Department of Health and Human Services.

New Hampshire is the only state to not have such a system, according to Lisa Morris, director of the department’s Division of Public Health Services.

“We need a working registry because immunizations save lives,” Morris said. “And so we want to make sure that providers and individuals and families have the information they need to keep up to date on their immunizations.”

But while the vote was unanimous, the discussion was contentious. Councilors took department officials to task for a $1.3 million contract in 2014 that was supposed to create a similar registry but didn’t become fully operational.

And a crowd of activists – many opposed to a registry for users of vaccines – waved signs expressing frustration with how the department had handled the project in the past.

“No CDC money to DHHS,” read one sign. “We want our money back,” stated another.

Laura Condon, the New Hampshire advocacy director for the National Vaccine Information Center – a national group opposed to mandated vaccinations – argued that the opposition was centered around state mismanagement.

“My issue today is not ‘do you want this law to exist or not,’” she said. “...This is money that was given in 2014 and not used for the purpose that they represented it will be used for in 2014.”

The database funded by the CDC would be confidential to the public and would “help providers and patients determine when immunizations are due and help ensure people only get the vaccinations they need,” DHHS said.

That could allow providers to prompt patients if they forget a flu-shot, for instance.

The system would also allow the state to place more accurate orders for publicly funded vaccines, the department added.

Still, it isn’t the first attempt the state has made to create an immunization registry. In 2014, the Executive Council approved a similar contract with Scientific Technology Corporation (STC) for $1.36 million to help set up such a system.

Back then, the state had a much bigger financial stake – with the federal government contributing 9% of the costs and the state taxpayer picking up the lion’s share.

Yet while public health officials managed to use that money to create a vaccine ordering and inventory system to distribute vaccines, they did not fully implement the registry.

The state created the structure for a registry but ultimately decided not to link providers because they had last-minute concerns with pending software upgrades to STC’s system, Morris said.

The new funding will allow the state to start from scratch with a new vendor – Envision Technology Partners – which Morris said other states have used successfully.

But the admission of missed expectations the first time around prompted a barrage of questions from councilors.

“I am not opposed to the registry,” said Councilor Ted Gatsas, a Manchester Republican. “Not for a second. What I’m opposed to is that we’re going to build another black box.”

Gatsas said that the department should have been more careful with how it chose its vendor the first time around, and should have informed the Council when issues with CTC first arose.

“Governor, I’m going to support this,” Gatsas said at the end of a half-hour discussion. “But I’m going to depend on you to make sure that you look at (the contract) before there’s anybody that says ‘we’ve got a final deal.’”

Councilor Russell Prescott, a Kingston Republican, registered similar concerns before also voting yes.

Morris expressed hope that the new vendor would deliver a better system. This time, the money would come entirely from the federal government, Morris said, with an aim to build up the system properly.

“I have no way of saying to you at 100% that Envision is going to be 100% effective,” she said. “But I do know that the states that are using it are very happy with the use of their particular system.”

Wednesday’s vote does not automatically create the new registry system, but instead allows the state to accept the federal money.

State officials will still have to negotiate a contract with Envision and bring that contract proposal before the Executive Council for final approval.

But the funding, which was granted to the state “with only very short notice” in September 2019, has only been provided for a limited duration. The state has until the end of June 2020 to get a contract in place, Morris said.

The New Hampshire department is unlikely to put the contract out to bid, but will rather attempt to secure a sole source contract through Envision, Morris added.

Morris’s comments weren’t reassurance for the two dozen advocates speaking against the contract, some of whom didn’t want a registry at all. 

To Condon, DHHS should not be using some of the money to pay for vaccines to be ordered and distributed by the  state. 

“We are not done here,” she said. “They will come back with a contract, I will be in touch with the governor, and we will make it darn sure that contract is not to continue to pay somebody for ordering and inventory, when they have no statutory authority to do so.”

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