Doctors, nurses and other public health professionals are speaking out against a bill that would dismantle New Hampshire's universal childhood vaccine purchasing program, saying it would increase barriers to vaccination and put kids’ health at risk.
The bill – along with several others that would weaken childhood vaccination requirements – comes at a time of declining childhood vaccination rates, in New Hampshire and around the country.
In the current school year, only 89.2% of kindergarteners had documentation showing they were up to date on all required vaccines, according to data from the state health department. That’s down from 91.5% in 2019, and well below the 95% threshold experts say is needed to prevent outbreaks of highly infectious disease like measles.
The bill comes at a time of declining childhood vaccination rates, in New Hampshire and around the country.
The state currently buys vaccines for children and supplies them to health care providers at no cost, using a combination of federal funds and payments from insurers. Doctors’ offices can then offer them to all pediatric patients free of charge.
A bill proposed by seven Republican lawmakers would effectively end that program by eliminating the organization that funds most of it: the New Hampshire Vaccine Association. It exists solely to collect money from insurers used to subsidize pediatric immunizations, an estimated $24 million annually.
While the state would still be able to use federal funds to purchase vaccines for uninsured children and children covered by Medicaid, it would no longer be able to do so on behalf of children who are covered by private insurance.
At a hearing Wednesday, doctors and nurses said that change would upend a system that’s made routine vaccines widely available to any kids who need them. Some said they would no longer be able to offer vaccinations for privately insured children, because it would be too expensive and hard to administer.
“Organizations like ours can’t afford to purchase these vaccines, paying up front and not knowing whether they will be adequately reimbursed,” said Dr. Kate Peters, a family physician at Amoskeag Health, a nonprofit health center in Manchester that serves many low-income families.
Peters warned that would make it harder for parents who want to vaccinate their children.
“This would result in families needing to change practices or take their kids to separate appointments to get vaccinated, which means more days off work, more stress and fewer kids getting vaccines overall,” she said.
State health officials say costs would rise
At Wednesday’s hearing, the lead sponsor, Rep. Michael Granger of Milton, described his bill as a way to save taxpayers money. But Granger largely deferred to Laura Condon, a local anti-vaccine activist and New Hampshire director of advocacy for the National Vaccine Information Center, to explain his bill. The National Vaccine Information Center is a nonprofit advocacy organization that spreads anti-vaccine misinformation, including the debunked claim that vaccines cause autism.
“I do not believe that DHHS should be in the business of buying and selling vaccines for commercially insured children,” said Condon, who previously held a public seat on the vaccine association’s board.
In fact, officials with the state health department said costs would go up if the program were repealed. The state can buy vaccines at a nearly 30% discount, which wouldn’t be the case for individual health care providers.
Health officials also estimate that if the bill passed, the state would need to spend an extra $100,000 a year to buy vaccines in the event of outbreaks and disaster relief efforts.
Repealing the universal vaccine program could be especially hard on safety-net providers, said Kristine Stoddard with the Bi-State Primary Care Association, which represents nonprofit health centers in New Hampshire and Vermont.
One of those centers, Coos County Family Health Services in Gorham, is the only primary care provider in its area. Coos County has had the highest school vaccination rate in the state for the past three years, and Dr. Brian Beals, a pediatrician there, said the state vaccine-buying program is a key part of that.
"Any kid we see can get any vaccine that is appropriate for their age, and we don't have to worry about where they live, what insurance they have."Dr. Brian Beals, pediatrician
“Any kid we see can get any vaccine that is appropriate for their age, and we don't have to worry about where they live, what insurance they have,” he said in an interview Tuesday.
If that were to end, his practice would have to pay tens of thousands of dollars up front for vaccines – with no guarantee of getting that money back if insurers reimburse too little or vaccines expire. That’s to say nothing of the additional administrative headaches.
Beals said something like that happened when an RSV immunization for infants came out in winter 2023-24. Because that was technically an antibody treatment, not a vaccine, it wasn’t included in the state purchasing program.
“The stuff we got from the state last winter, we could only give to Medicaid children or someone who was truly uninsured,” he said. “So all of our privately insured people actually, last winter, didn't get it.”
The House Health, Human Services and Elderly Affairs Committee did not immediately vote on the bill Wednesday.
