The immunization registry is a tested and standard tool that provides critical information on vaccinations for use in monitoring immunization programs, guiding public health action, and keeping accurate records. It is used by 49 other states and Washington, D.C.

The more information in the registry, the more useful the database is to public health, which is why I urge lawmakers to oppose House Bill 1606.

This bill would change the immunization registry from opt-out to opt-in, creating new barriers to participation, limiting the data available and leaving the state without a critical tool to inform its public health response.

The New Hampshire registry, the Immunization Information System (NHIIS), was adopted in 2021 and was a huge step forward for New Hampshire data collection around immunization and communicable disease. It was created with the intent to consolidate a citizen’s immunization information from multiple New Hampshire healthcare providers who participate in NHIIS into a single reliable record.

Keeping immunization information in one location helps providers know what immunizations you and your family have had and which immunizations you will need in the future. In the event someone relocates or moves, changes their healthcare provider or providers, during natural disasters, all participating healthcare providers will have access to immunization information. Or, in the event of a disease outbreak, NHIIS will assist in identifying when a patient requires immediate vaccination.

I’m most concerned about the NHIIS benefits that can help us better reach the most vulnerable populations. The system is not a tool to spy on citizens and target them because of their vaccination status — an unfortunate assumption made during this tenuous pandemic political climate.

The current law allows for individuals and families to opt out of the system, while HB 1606 would make it so patients have to explicitly opt in to NHIIS. Changing the system to opt-in will erect barriers for patients and providers alike and minimize the impact this public health tool can potentially have on the health of New Hampshire.

When a patient has to opt in, we are creating more administrative barriers for an already overburdened healthcare system. In addition, if providers are not able to have enough of their patients opt in, they potentially lose the benefit that the system is meant to provide. The usefulness and success of NHIIS is contingent on the enrollment of as much of the population as possible. Public health departments such as my own can run reports and see whether there are certain ZIP codes or neighborhoods that require more outreach to improve immunization among school-aged children, for example.

But let’s consider something that gets people’s attention: money.

“Obtaining affirmative consent imposes significant costs,” writes Alan McQuinn, a policy analyst with the Information Technology and Innovation Foundation. Researchers, he said, “attempted to calculate the cost for hospitals if the Texas government adopted opt-in policies for tracking immunization health records for children in the state.

The study found that obtaining consent for each child born in the state would cost roughly $1.4 million, or roughly $2 per child per year. Conversely, switching to an opt-out system would reduce this annual cost to $110,000, or 29 cents per child, which could redirect limited healthcare funding to critical areas, such as vaccine purchasing.” That was 2010; costs have increased since then.

In order to progress and continue to keep our citizens safe and healthy, it’s essential that we encourage participation in the NHIIS registry, not discourage it with opt-in policies that throw up barriers to participation. I encourage representatives to vote against HB 1606 and protect the public’s health and safety long after this time in our history is past.

Jane Goodman is a public health network strategist for the city of Nashua’s Division of Public Health and Community Services.