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NH public health officials warn against changing child care vaccination rules

A close-up of a health care worker's hands in disposable gloves administering a shot to someone's arm.
AP
New Hampshire lawmakers are considering eliminating a requirement that parents demonstrate their kids have had routine childhood vaccinations before enrolling them in child care.

Proof of routine childhood vaccinations would no longer be required before kids are enrolled in child care, under a bill being considered by New Hampshire lawmakers.

The bill, which passed the New Hampshire House last month, is one of several attempts lawmakers have made to roll back public health measures in recent years.

New Hampshire currently requires kids to be immunized against certain diseases before they can be enrolled in child care. Depending on their age, that includes polio, measles, chickenpox and hepatitis B. (The COVID-19 vaccine is not required, and exceptions are made for religious or medical reasons.)

During a Senate hearing Wednesday, health officials warned against lifting vaccination requirements for child care enrollment, saying that could lead to fewer kids getting routine childhood immunizations and contribute to outbreaks of preventable diseases.

“Infectious diseases that were once eliminated from the U.S., such as measles and polio, are now making a comeback because of under-immunization,” said Dr. Benjamin Chan, the state epidemiologist.

He pointed out that measles was eliminated from the United States in 2000. But this year, there have been over 120 cases nationwide.

None of those cases were in New Hampshire. But Chan said the state has seen a concerning drop in the number of children getting the measles, mumps and rubella, or MMR, vaccine.

In the 2022-23 school year, 89.4% of New Hampshire kindergartners had the MMR vaccine – the lowest rate in New England and below the national average.

Because measles is so contagious, at least 95% of a population needs to be vaccinated to create herd immunity and prevent outbreaks, according to the Centers for Disease Control and Prevention.

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“As vaccination levels decrease, this is putting our children and our communities and our child care agencies at risk,” Chan said.

The current state law says no child can be “admitted or enrolled in any school or child care agency” without documentation they’ve had the required vaccinations or qualify for an exemption. The bill would remove child care agencies from that requirement, as well as a requirement that they keep immunization records for every child.

Republican Rep. Ross Berry of Manchester, one of the sponsors, said the bill is about eliminating a “needless paperwork requirement” that he called burdensome for child care providers. Berry, who runs a child care center, disputed the idea that the bill removes the vaccination requirement itself, as opposed to just the reporting requirements.

But Chan and other officials with the Department of Health and Human Services disagreed. They said that, in their reading, the bill actually does get rid of vaccination requirements for child care enrollment – and even if it didn’t, they argued those requirements would be meaningless without any way of ensuring compliance.

Health officials said lifting vaccination requirements could also put federal funding for child care at risk.

The bill is currently in the New Hampshire Senate’s Health and Human Services Committee.

Since the onset of the COVID-19 pandemic, New Hampshire lawmakers have proposed various measures to limit public health powers at the state or local level.

On Wednesday, state senators also heard testimony on a bill that would prohibit school districts from imposing mask mandates, which has also passed the House. Gov. Chris Sununu vetoed a similar bill in 2022, citing the importance of local control.

Paul Cuno-Booth covers health and equity for NHPR. He previously worked as a reporter and editor for The Keene Sentinel, where he wrote about police accountability, local government and a range of other topics. He can be reached at pcuno-booth@nhpr.org.
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