Hepatitis B and other diseases deemed “non-communicable in a child care or school setting” would be removed from the list of vaccines required by the state under a bill that got a surprise boost Wednesday, Feb. 22, from a House committee.

The bill, passed by the House Health, Human Services and Elderly Affairs Committee on a 9-8 vote, says the vaccines cannot be required for enrollment in public school or child care facilities.

Hepatitis B, which is transmitted by bodily fluids generally during sexual intercourse or the sharing of needles by drug users, is the only disease that would be affected if the bill became law. The wording targets other lifestyle diseases such as HPV, or human papillomavirus, that some health officials argue should be added to vaccination mandates.

The vaccine against HPV, a virus usually acquired during sex that can cause cancer, is not required in New Hampshire. The federal Centers for Disease Control and Prevention recommend that it be given, but individual states can decide which shots to mandate.

Wednesday’s vote sends the bill, House Bill 362, to the full House of Representatives for consideration. Because Hepatitis B vaccinations are often given at birth, even if the law passes, it will not have an immediate effect.

Wednesday’s vote came after the committee had squashed – with a 17-2 vote – a related bill, House Bill 361, that would have prevented the Commissioner of the Department of Health and Human Services 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.

Both bills were supported by groups like Health Freedom New Hampshire, which is opposed to mandatory vaccination of any kind, and in some cases opposed to vaccinations in general.

State law mandates children have vaccinations for seven diseases including measles, mumps and tetanus before enrolling in school or child care, while the Department of Health and Human Services has used its rule-making authority to add requirements for vaccinations against chicken pox, Hepatitis B and Haemophilus Influenza.

The two bills discussed Wednesday reflect a national debate about childhood vaccines for diseases that are related to sexual and drug-related activity and usually do not occur until later in life.

Many of the diseases are devastating: Hepatitis B is a serious liver disease that can kill people, while HPV can lead to a variety of cancers.

Public health advocates say giving these vaccines to children or infants maximizes the benefit to society, reducing the extent of debilitating diseases in high-risk populations, such as drug users who are unlikely to get vaccinated when they are teens or adults.

Opponents argue that safety concerns that come with any vaccine and questions about longtime efficacy of the vaccines change the risk-benefit calculation of requiring them for attendance in public school and child care, since, unlike other vaccines, they bring little or no benefit to children at the time they get the shots.

Further, because the diseases associated with these vaccines are usually related to drug use and sexual activity, the debate has also become politicized. The 9-8 vote by the Health Committee was largely, but not entirely, along party lines, with most Republicans voting for the bill’s passage and most Democrats opposing it.

The CDC recommends that vaccines be given for a total of 16 diseases. Exemptions from vaccinations are allowed in New Hampshire for medical or religious reasons, but the Legislature has rejected attempts to allow exemptions based on parental preference.

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