The New Hampshire Public Health Association will invite members to monthly meetings starting January through June 2023. At the monthly meetings, the committee planning team will share policy updates and engage the membership to take an active role in the upcoming legislative session. If you have any questions, please contact Hanan Bedri, Executive Director at email@example.com. Meeting dates and times to be announced later this fall.
Laws, regulations, and public policy can have a major effect on public health and the future of immunization in New Hampshire. The New Hampshire Public Health Association's VaxWell NH Coalition utilizes education and advocacy to help enact effective policies that support both population-based and individual health throughout our state and communities. The NHPHA leads VaxWell NH Coalition's advocacy efforts by tracking vaccine legislative bills and looks at policy matters in terms of their potential impact on the public's health in New Hampshire. Our advocacy work ranges from action alerts to legislative updates, giving testimonies, and lobbying on behalf of VaxWell NH Coalition members. Our goal is to increase awareness within our membership, influence relevant regulations and legislation, and support pro vaccine partners who share our mission of reducing vaccine-preventable disease by increasing immunization rates in the State of New Hampshire.
Health in All Policies
The Health in All Policies (HIAP) e-Newsletter is published weekly during the legislative session and is your resource for legislative updates in New Hampshire.
By Suzanne Allison, RN BSN, Member of the VaxWell NH Coalition and the New Hampshire Public Health Association
February 16, 2022 -- As a 45-year resident of New Hampshire and someone who votes in every election and as a retired public health nurse with almost 40 years of community and public health experience in the Granite State, I have urged the members of the House Health, Human Services and Elderly Affairs Committee to oppose HB 1606.
The NH Immunization Information System or NHIIS (also known as New Hampshire’s vaccine “registry”) is 15 or more years behind any other state IIS in the country. As the last state to even have an IIS, many roadblocks prevented New Hampshire’s initial system from becoming the functioning tool it was meant to be, and a new vendor was contracted in 2019. As New Hampshire was getting ready to launch its first fully functioning IIS, with all of the attendant education, support and outreach required, the pandemic hit.
This not only forced a rapid rollout of certain features of the IIS required for COVID-19 vaccination efforts, but the healthcare crises occurring in hospitals and provider offices have made it extremely difficult for all parties (healthcare providers, patients and families, and public health) to realize the benefits and value of a high-quality IIS.
Making the NHIIS “opt-in” will only delay the process further and seems meant to promote its failure. And it is not necessary as patients can already opt-out if they do not want their information in the NHIIS.
These are the benefits of a robust and fully functioning IIS:
Provides consolidated records: Containing immunizations administered at a previous provider office, hospital, pharmacy or school clinic give healthcare providers the full story, preventing patients from receiving too many or too few vaccines
Manages vaccine inventory: Vaccine ordering, tracking and administration are all managed in one tool
Minimizes waste: Ensures every vaccine is accounted for and prevents the administration of unnecessary doses of vaccines
Forecasts immunizations: Alerts notify providers to assist with clinical decisions and management of the complex immunization schedule
Reminds patients of due dates: Automatic reminders promote on-time vaccinations
Spotlights areas of need: Population-level vaccine coverage data provides a clear view of communities at risk
Expedites response in an outbreak: Insights into vaccination status set the stage for effective outbreak response (including a measles or hepatitis A outbreak, not just during a pandemic.)
According to a review of state IIS policies in 2015 (Martin, Daniel W. MSPH; Lowery, N. Elaine JD, MSPH; Brand, Bill MPH; Gold, Rebecca JD; Horlick, Gail MSW, JD Immunization Information Systems, Journal of Public Health Management and Practice: May/June 2015 – Volume 21 – Issue 3), other states’ IIS policies and laws range from highly restrictive (such as immunizations only included on an opt-in basis) to mandatory inclusion with no opportunity to opt-out of the IIS.
The majority of jurisdictions either mandate reporting or use implied consent, in which the patient/parent/guardian is notified of the requirement to report and offered the opportunity to opt-out. National public health experts recommend opt-out consent policies when feasible in order to lower the barrier to comprehensive reporting to IIS. Such policies respect an individual’s right to privacy, including the right to exclude information from public health databases, while maximizing the availability of needed data for quality care and public health.
It has been suggested that switching from opt-in to opt-out could save more than $1 million per year in one state and at least one study has suggested that opt-out policies may correlate with improved immunization coverage.
Why would New Hampshire go backward and switch from opt-out to opt-in? This is bad public health policy and bad for the citizens of New Hampshire.
Older Granite Staters on Medicare Need Equal Access to Vaccines
By Suzanne Allison & Ashley Ithal
THE COVID-19 pandemic has highlighted the value of vaccines as an important measure of protection, one without which many more Americans and Granite Staters would have succumbed to the insidious virus.
The pandemic has also focused attention on health inequities across populations in terms of access to the vaccines and testing. We must strive to do better.
One such inequity that is too often overlooked impacts Americans over the age of 65, and especially minorities over the age of 65. We’re talking specifically about Medicare Part D’s coverage of vaccines, or lack thereof. Part D still allows health insurance plans to charge significant cost-sharing for many routinely recommended adult vaccines. This results in lower immunization rates among older Americans, putting them at risk of severe illness or even death from vaccine preventable diseases. It also increases healthcare costs because patients end up seeking medical care, or in the hospital, adding stress to our health care system in general, something we can’t afford.
Vaccines are the gold standard of preventative measures to protect us, first, as children, against diseases like measles, mumps, whooping cough and more, and then as adults against diseases like pneumonia and shingles. Having access to vaccines is critical at all stages of life, but many older Americans are deterred from getting them because of prohibitively expensive copays and cost sharing. The Protecting Seniors Through Immunization Act (S 912/HR 1978) would eliminate Medicare vaccine copays and cost sharing for Part D beneficiaries, aligning it with Part B, which covers the complete cost of pneumococcal and influenza vaccines for those over 65.
This is a bill that is based on sound data that points to the necessity of reducing barriers to achieving public health.
For more than 25 years, we’ve prioritized removing cost barriers for childhood vaccines and it’s been a huge success. In addition, the Affordable Care Act requires that all insurance plans cover preventative care, including vaccines for adults, without cost sharing. Why haven’t we extended this valuable access to vaccinations for adults who rely on Medicare?
When congressional lawmakers passed the CARES act, everyone, including those on Medicare, was protected from any kind of cost sharing associated with the COVID-19 vaccines. The idea was to get as many people vaccinated as possible. They should do the same when it comes to other life-saving preventative medicines. Removing the cost barrier for Part D beneficiaries is the right thing to do from a public health perspective. It’s our sincere hope that New Hampshire’s congressional delegation will support this bill and work across the aisle to get it passed.
Many of us rely on Medicare, will rely on it, or have loved ones who rely on it.
Older Americans on Medicare should have the same access to all recommended vaccines as our children and insured adults. They shouldn’t have to worry about whether they can afford to be immunized against potentially deadly diseases. It’s as simple as that.