Effort to pull hepatitis B vaccine school requirement shot down

  • A research assistant prepares a syringe inside a pharmacy glovebox. Sumit Dayal / Bloomberg

Monitor staff
Friday, April 07, 2017

Children entering public school and day care in New Hampshire will continue to need vaccinations against hepatitis B, after a Senate committee on Thursday killed the latest of several attempts to end the requirement.

In a 5-0 vote, the Senate Health and Human Services committee killed an amendment proposed by Rep. Valerie Fraser, R-New Hampton, that would have added “the hepatitis B vaccine not be an immunization requirement” to a bill about school vaccines.

A number of medical professionals testified against removing the hepatitis B requirement, which has been in place in the state since 1996. They included the state epidemiologist, the head of the state’s infectious disease bureau, two state representatives who are physicians (one a Republican, one a Democrat) and two other family physicians.

“This is not a disease that should be taken lightly,” said Dr. Travis Harker of the Concord Family Health Center, who said he had one patient who got the disease as an adolescent and later died.

Hepatitis B is a liver disease transmitted through bodily fluid. It is far more common in teenagers and adults than in children or infants, and is most often transmitted through shared needles during drug use or via sex.

Opponents to the vaccine requirement argue that transmission in elementary school classrooms is so unlikely and so rare that the possibility of children having a reaction to the shot outweighs any benefit. They say the shots are required not because of schoolyard risk, as is the case for other vaccine requirements, but only because the sort of people who are later at risk are unlikely to get vaccinated.

“It’s not because it is occurring in that population, but because it is a receptive population,” said Laura Condon, who serves the state chapter of anti-vaccine group the National Vaccine Information Center.

Also speaking against the requirement was state Rep. Werner Horn, R-Franklin, who argued that it removed parents’ rights.

“Parents should be allowed to make the choices to keep their children safe,” he said, drawing parallels to the way parents now make their children wear bicycle helmets as information becomes available, without it being mandated. “You’re telling New Hampshire parents we don’t trust them to make health decisions for their children.”

In her testimony, Elizabeth Daley, the chief of the Bureau of Infectious Disease Control at the state Department of Health and Human Services, argued that this parallel was flawed because vaccines help keep people from spreading disease to others. That is particularly true for hepatitis B, which, unlike other childhood diseases covered by the state’s vaccination requirement, often produces no symptoms, she said.

“You’re putting other children at risk – it’s a little different that the bike helmet,” she said.

New Hampshire law mandates children have vaccinations for seven diseases including measles, mumps and tetanus before enrolling in school or child care. DHHS has used its rule-making authority to add requirements for vaccinations against chicken pox, hepatitis B and haemophilus influenza.

Earlier this year the House Health, Human Services and Elderly Affairs Committee squashed a bill, House Bill 361, that would have prevented the commissioner of the DHHS from using rule-making authority to add vaccines to the requirement list. If that bill had passed, only the full Legislature could have changed the list of required vaccines.

The bill debated in the Senate committee Thursday, House Bill 362, originally said that vaccines could not be required for diseases that are “non-communicable in a child care or school setting,” wording that targeted hepatitis B and other vaccines against what are sometimes called lifestyle diseases, usually because they are most often passed on via sex or drug use. Those provisions were stripped away during passage through the House of Representatives, resurrected and then removed again before the bill went to the Senate.

The bill now states only that vaccines should not be required for “non-communicable diseases.” Several medical professionals said Thursday this statement is virtually content-free, since vaccines only exist for diseases that are communicable. Passing the bill will make no changes to any medical or inoculation practices, they said.

In this “innocuous” form, as several people described it, without the hepatitis B amendment, the bill passed the committee 5-0 Thursday and will be put on the consent calendar for debate-free consideration by the full Senate.

(David Brooks can be reached at 369-3313 or dbrooks@cmonitor.com or on Twitter @GraniteGeek.)