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Vaccine Exemptions Under Attack in 2019

Analysis by National Vaccine Information Center Fact Checked

vaccine exemption

Story at-a-glance -

  • In 2010, the National Vaccine Information Center (NVIC) launched the NVIC Advocacy Portal, a free online vaccine choice advocacy network, for the purpose of securing and defending informed consent protections in vaccine policies and laws
  • During the 2019 legislative session, 22 bills across 17 states were filed to attempt to eliminate vaccine exemptions. Three bills passed, 12 died and seven are still pending in California, Massachusetts, New Jersey, Pennsylvania and Wisconsin
  • While media hyped bills attacking exemptions, there were almost as many bills to expand informed consent rights as there were to eliminate or restrict those rights. This can be directly credited to positive action taken by forward-thinking state legislators given fact-based information about vaccines, exemptions and diseases by concerned citizens who took the time to make one-on-one personal contact with their elected representatives
  • Of the 137 vaccine-related bills NVIC opposed, only 18 bad bills passed
  • It is critical that vaccine choice advocates in every state register for and check in to the NVIC Advocacy Portal. The most important thing you can do is to establish relationships with and educate your legislators now and into next year so you can be ready to counter bills that will restrict or eliminate exemptions and get good bills filed to protect and expand vaccine exemptions

Citizen involvement in the legislative process to protect the human right to exercise informed consent to vaccination increased to unprecedented levels in 2019 to meet the most aggressive and unwarranted attack on vaccine exemptions in U.S. history.

In a 2019 Annual Report on U.S. State Vaccine Legislation, the nonprofit educational charity National Vaccine Information Center (NVIC) reports that during the 2019 legislative session, 22 bills across 17 states were filed to attempt to eliminate vaccine exemptions.

Three bills passed, 12 died and seven bills are still pending in California, Massachusetts, New Jersey, Pennsylvania and Wisconsin at the time of writing. Status on all bills in this report reflect their positions on September 9, 2019.

Working to prevent vaccine injuries and deaths through public education since 1982, NVIC is the largest and oldest U.S. charity disseminating information about diseases, vaccines and informed consent to vaccination.

NVIC provides well-referenced, accurate information to the public about vaccine science, policy and law but does not make vaccine use recommendations. In 2010, NVIC launched the NVIC Advocacy Portal (NVICAP), a free online vaccine choice advocacy network, for the purpose of securing and defending informed consent protections in vaccine policies and laws.

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NVIC works alongside and shares legislative information with many health freedom groups that support NVIC's more than three-decade call for the protection of vaccine informed consent rights in America.

The NVIC Advocacy Portal team, including key NVIC advocacy directors in many states, works with families and enlightened health care professionals to educate legislators and protect vaccine informed consent rights.

During the 2019 legislative session, NVIC analyzed, tracked and issued positions on an unrivaled 221 vaccine related bills and five sets of rules in the following 40 states and the District of Columbia through the NVICAP: Alabama, Arkansas, Arizona, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Vermont, Washington, Wisconsin, West Virginia and Wyoming.

Forty-two vaccine-related bills are still pending in California, District of Columbia, Massachusetts, Michigan, New Jersey, Ohio, Pennsylvania and Wisconsin, and action to support the good bills and fight against the bad bills is still needed.

Bills referenced in this report are published on the NVICAP and registered users can obtain a more detailed bill analysis, including current status, NVIC's position on the bill and recommended action.

Highlights From 2019

There were significant positive takeaway points from the outcome of the 2019 legislative session:

  • Of the 40 bills filed across 22 states (Alabama, Arizona, California, Colorado, Connecticut, Iowa, Illinois, Massachusetts, Maine, Minnesota, Missouri, Montana, New Jersey, Nevada, New York, Ohio, Oregon, Pennsylvania, Texas, Vermont, Washington, Wisconsin) to either eliminate or restrict some vaccine exemptions, five passed: California SB 276 and SB 714, Maine LD 798, New York A2371A, and Washington EHB 1638; 12 are pending and 23 died
  • Of the 137 vaccine-related bills that NVIC opposed, only 18 bad bills passed
  • The 2019 legislative session featured more proposed vaccine-related bills worthy of support (77) than any legislative session since the launching of NVIC's Advocacy Portal in 2010.

There were six states with 10 or more vaccine-related bills filed this session. Texas has the record with 29 bills; New York can be credited with 19; New Jersey currently has 13; Arizona finished with 11, and Connecticut and Iowa both ended sessions with 10 bills each.

The remaining vaccine-related bills that either passed or were defeated in states during the 2019 legislative session are broken out and described below by category.

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2019 Bill Analysis by Category

The four main areas that NVIC focuses on when tracking proposed bills are:

  1. Vaccine exemptions and informed consent rights
  2. Vaccine mandates
  3. Vaccine tracking and reporting
  4. Vaccines in general

Some bills may be included in multiple categories. For example, a proposed bill attempting to mandate a vaccine may also have a requirement for vaccine tracking so it would be counted in both categories but only counted once in the total bill count.

The NVIC Advocacy team provides referenced, accurate vaccine information and talking points for NVICAP users to background legislators. Some of the position statements NVIC posted on the Advocacy Portal in 2019 were listed as bills to "watch" because our analysis indicated they contained sections that could be vulnerable to amendments that would conflict with NVIC's mission.

The breakout and analysis of bills in these different categories identify trends across the states and serve as a guide if you want to become active by joining the NVIC Advocacy Portal (NVICAP) and educating your state legislators and community in 2020 about why it is so important to protect vaccine informed consent rights.

Vaccine Exemptions and Informed Consent (122 Bills)

The surprising story about this session is that of the 122 vaccine-related bills filed in state legislatures in 2019, which had components that affected vaccine exemptions and informed consent rights, NVIC opposed 63 of the proposed bills, but supported 58 and "watched" one.

Media tended to hype the bills attacking exemptions so much that it may come as a surprise that there were almost as many bills to expand informed consent rights as there were to eliminate or restrict those rights.

This can be directly credited to positive action taken by forward-thinking state legislators who were given fact-based information about vaccines, exemptions, and diseases by concerned citizens who took the time to make one-on-one personal contact with their elected representatives.

Eliminating or Restricting Vaccine Exemptions

The most significant concerning trend coming out of the 2019 legislative cycle is that 40 bills were filed to either remove or restrict vaccine exemptions in the following 22 states: Alabama, Arizona, California, Colorado, Connecticut, Iowa, Illinois, Massachusetts, Maine, Minnesota, Missouri, Montana, New Jersey, Nevada, New York, Ohio, Oregon, Pennsylvania, Texas, Vermont, Washington and Wisconsin.

There were 22 bills filed in the following 17 states attempting to eliminate vaccine exemptions: Alabama, Arizona, California, Iowa, Massachusetts, Maine, Minnesota, Missouri, New Jersey, New York, Ohio, Oregon, Pennsylvania, Texas, Vermont, Washington and Wisconsin. Of these 22 bills, three passed; seven are still pending and need strong opposition; and the other 12 failed to pass.

Maine LD 798 eliminated both the religious and philosophical exemptions and goes into effect September 1, 2021. This bill narrowly passed the house and senate and families in Maine need to work with legislators to repeal the removal of these exemptions.

New York A 2371A eliminated the religious exemption in one day with no public hearings and the law goes into effect immediately leaving only a restrictive medical exemption.

There are ongoing legal efforts by Children's Health Defense to challenge the new law and the implementation schedule. New York's repeal of the religious exemption violates the rights of the disabled under The Rehabilitation Act Of 1973. The religious exemption in New York needs to be reinstated by the legislature in 2020.

Washington EHB 1638 eliminated personal and philosophical exemptions to MMR vaccines only, leaving philosophical exemptions for all other vaccines and religious and medical exemptions for all vaccines including MMR as of July 28, 2019. It could have been much worse, as WA SB 5841 attempted to remove all religious and philosophical exemptions for all vaccines, but this bill was unnecessary.

Seven remaining bills still active, which are attempting to remove exemptions that deserve strong vigilant opposition, are:

  • California AB 283 seeking to eliminate the personal belief exemption for young children using the CalWORKs assistance program
  • New Jersey A 3818, which is trying to eliminate the religious exemption
  • Massachusetts H.3999 and HD 4284, which are trying to remove the religious exemption
  • Pennsylvania SB 653, which is aiming for the removal of religious and philosophical exemptions,
  • Wisconsin AB 248 and SB 262 that would strike personal conviction vaccine exemptions

Although not included in this report's 2019 tally of bills, it is worth highlighting a highly aggressive early attack on the vaccine exemptions in Florida. SB 64 was filed in advance of the 2020 legislative session by Florida state Sen. Lauren Book, a Broward County Democrat, to eliminate the religious exemption and restrict the medical exemption.

Florida families can refer to the alert and information on the NVIC Advocacy Portal on how to communicate with legislators about opposing this bill and asking the bill sponsor to withdraw the bill.

There have been 18 bills and two sets of rules proposed to restrict vaccine exemptions across these 12 states: California, Colorado (both a bill and a rule), Connecticut, Hawaii (rule), Illinois, Massachusetts, Montana, New Jersey, Nevada, New York, Oregon and Pennsylvania.

So far, only two of the bills have passed, California SB 276 and SB 714, which together significantly restrict the medical exemption. Four bills in Massachusetts, New Jersey and Pennsylvania remain active and need strong opposition.

In Hawaii, a new rule was unfortunately adopted and signed by the governor to restrict the medical exemption by confining it to the restrictive language "due to a stated cause" and "in conformance with recognized standard medical practices."

"Recognized standard medical practices" means in accordance with the United States Department of Health and Human Services' Advisory Committee on Immunization Practices (ACIP), General Best Practice Guidelines for Immunization and future amendments that are adopted by the department.

This restriction goes into effect July 1, 2020. Citizens in Hawaii should work hard to reverse this through the legislature in 2020 in advance of this rule going into effect.

The debate surrounding a draft of a proposed rule in Colorado to mandate that parents use state forms to file vaccine exemptions is ongoing. The information on voicing opposition, once and if the rule is formally proposed, will be posted on the Colorado page on the NVICAP. Bills pending to restrict vaccine exemptions that deserve continued strong opposition include:

  • Massachusetts HD 4470 and SD 2548 to restrict medical and religious exemptions by requiring state scrutiny and approval
  • New Jersey S 2173 to significantly restrict the religious belief exemption
  • Pennsylvania HB 1771 to require annual medical consultations to use a religious and philosophical exemption
  • Pennsylvania SB 626 to require certification of religious exemptions by vaccine administrators

These bills need to continue to be opposed. Vaccine choice advocates came out by the thousands in record numbers in many states and successfully held back multiple other attacks to remove or restrict vaccine exemptions in Alabama, Arizona, Colorado, Connecticut, Illinois, Iowa, Minnesota, Missouri, Montana, Nevada, Ohio, Oregon, Texas, Vermont and Washington.

It is critical that vaccine choice advocates in every state register for and check in to the NVIC Advocacy Portal. The most important thing you can do if you care about this issue is to establish relationships with and educate your legislators now and into next year so you can be ready to counter bills that will restrict or eliminate exemptions and get good bills filed to protect and expand vaccine exemptions.

There are a lot of possible activities that you could participate in and it is easy to get distracted with rallies and social media, but there is nothing more important that you can do to protect or expand your right to delay or decline vaccines without penalty or harassment than talking to your legislators in person and establishing a positive, respectful relationship with them.

Exemption Disclosure and School Shaming

One way that vaccine industry lobbyists place disruptive pressure on schools allowing students to enroll with vaccine exemptions is to lobby to pass legislation that requires individual schools to publish vaccination and vaccine exemption rates and publicly post that information online.

These bills are promoted under the guise of educating parents, but they are really about government-sponsored shaming that pits school against school and parent against parent for the purpose of marginalizing and increasing peer pressure on families whose children have vaccine exemptions.

Media will use these reports in a biased manner to reflect negatively on schools with more exemptions in an attempt to solicit support for further restricting or eliminating vaccine exemptions.

Some of these media companies, like the Texas Tribune, are funded heavily by organizations that support mass vaccination like the $1.7 million dollars the Tribune received from the Bill and Melinda Gates foundation. Other publications utilize paid content otherwise known as "native advertising" to take in money from businesses willing to pay for "articles" discrediting families delaying or declining vaccines.

Fortunately, of the 13 bills filed in this category in seven states, none has passed and the following nine bills died: Arizona HB 1786, HB 2353, and SB 1201; Oklahoma SB 925; and Texas HB 1966, HB 3551, HB 3883, SB 329 and SB 873. Bills in Massachusetts (HD 4470 and SD 2548), Michigan (HB 4610) and Pennsylvania (HB 1767) are still pending and deserve strong opposition.

Children Vaccinating Themselves?

A very troubling area of proposed legislative changes are bills that allow minor children to be vaccinated without the knowledge or informed consent of their parents. A child is less likely than an adult parent to understand their personal and family medical history, including a history of vaccine reactions, allergies and autoimmune or neurological disorders.

Minor children do not have the same kind of critical thinking skills or emotional maturity required to make a vaccine benefit-risk decision compared to an adult. In addition, if a child receives a vaccination without a parent's knowledge or informed consent and then experiences a vaccine reaction, a parent might not recognize the potential cause of their child's sudden decline in health.

This lack of knowledge by parents could be life threatening for the child. Fortunately, none of the 13 bills introduced in seven states that would allow minor children to consent to some or all vaccines without their parents' knowledge or approval has passed to date.

Connecticut SB 858 would have allowed minors to consent to HPV vaccines, and New York A 973 and S 3899A were confined to allowing minors to consent to sexually transmitted disease vaccines, but Georgia HB 615; Missouri HB 1075; New York A 6465B and S4244; Vermont H 515; pending District of Columbia B23-0171; pending Massachusetts HD 4470 and SD 2548; and pending New Jersey A 5399 and S 3835 would let minors of various ages consent to being vaccinated without parental knowledge or consent. See NVIC's Submitted Testimony Against D.C. B23-0171.

Expanding Vaccine Exemptions and Informed Consent

Hard-working vaccine and health freedom advocates and open-minded legislators came together to introduce 58 bills in the following 24 states to expand vaccine exemptions and protect informed consent rights: Arizona, Connecticut, Georgia, Hawaii, Idaho, Illinois, Iowa, Louisiana, Maine, Maryland, Mississippi, Missouri, Montana, New Hampshire, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Vermont, Washington and West Virginia.

Oklahoma passed an important bill, HB 2339, that requires prior written consent before a child can receive a vaccine at school. With more schools hosting clinics, there is an increasing risk for children to be vaccinated at school with vaccines the children didn't need or that the parent didn't want.

Legislators are increasingly recognizing problems created by forced vaccination policies where parents are not provided enough information about potential vaccine risks and contraindications and, in response, 23 bills were filed in 16 states tackling the issue of improving vaccine informed consent.

Arizona, Connecticut, Iowa, Illinois, Louisiana, Maryland, Missouri, Mississippi, Oregon, Texas and Vermont all had bills filed to require additional information to be provided prior to vaccination. Missouri, Montana, Oklahoma, Pennsylvania, Rhode Island and Texas had bills that either prohibited some form of discrimination or insurance kickbacks over vaccination status.

Pennsylvania HB 286, which is still pending, would prohibit insurance companies from denying a health care practitioner participation in an insurance plan or decreasing reimbursements based on vaccination rates or the practitioner's decision not to vaccinate.

Pennsylvania (HB 48) and Ohio (HB 132) have bills currently pending that would require schools to inform parents of their right to file vaccine exemptions. While none of the other bills passed, the increased attention by legislators indicates they are hearing the voices and concerns of their constituents.

There were 17 bills in 10 states that expanded vaccine exemptions. Of those, Hawaii, Iowa, Mississippi, Rhode Island and West Virginia all had bills to add conscientious or philosophical belief exemptions, while Arizona, Mississippi and West Virginia had bills filed that tried to add religious exemptions.

Recognizing the unnecessary and preventable risks of overvaccination, legislators in Arizona, New Hampshire, Oklahoma and Washington filed six bills to allow and expand the application of serologic proof of immunity.

Oklahoma, Oregon and Pennsylvania continue to break important ground taking a stand for parental rights. Oklahoma SB 861 was filed to clarify that refusing to vaccinate or delaying vaccination is not child abuse. In Oregon, both HB 2779 and SB 653 would have required parental consent before children taken into protective custody can be vaccinated.

While these bills did not pass, reining in state child protective services officials, who attempt to criminalize voluntary vaccine decision-making and override parental rights, is another area that state legislators can make a difference with proactive legislation.

Deserving strong support, Pennsylvania HB 286 is still pending and it prohibits child protective services from initiating an investigation on a parent or guardian for the sole reason of delaying or declining a vaccine.

Threats and outright denial of healthcare by physicians based on a patient's vaccination status are a growing problem in America and a number of state legislators are justifiably concerned about it and have become more open to considering bills to prohibit such abusive practices.

Two bills in Texas, HB 3857 and SB 2351, and Montana HB 711 would have protected patients from discrimination by health care providers over vaccination status, but did not pass. Pennsylvania families can still support pending HB 286 prohibiting discrimination by health care practitioners and health care facilitates against patients, or parents and guardians of patients, based solely on choosing to delay or decline a vaccination.

NVIC encourages families to educate their legislators about harassment and discriminatory practices by physicians, including denial of medical care, and to also share personal experiences related to threats and sanctions by physicians — or anyone else — for exercising vaccine informed consent rights by posting on NVIC's Cry For Vaccine Freedom Wall.

Vaccine Mandates (47 Bills)

Expanding Vaccine Mandates — In 2019, 17 of the 24 bills that proposed to add new vaccine mandates died. New Jersey and Massachusetts have seven pending vaccine mandate bills for adult health care workers and childhood HPV and meningococcal vaccines, which still need to be opposed.

So far in 2019, the only way that vaccine mandates have expanded has been through the rule making process initiated by state agencies. Hawaii Gov. David Ige signed a rule into effect to mandate ACIP-recommended vaccines, which includes HPV, meningitis and flu vaccines, and Kansas enacted a rule to mandate Hepatitis A and meningococcal vaccines for school attendance.

NVIC supported a resolution in Idaho, HCR 4, to reject a recently adopted rule which mandates a second dose of a meningococcal vaccine for 12th-grade students. This resolution failed in the legislature, but NVIC has a current alert on the NVIC Advocacy Portal for people in Idaho to participate in the rule review process to hopefully get this mandate removed.

Please follow alerts on the NVICAP to articulate concerns to legislators about these attempted expansions of the vaccine schedule by unelected unaccountable government agency employees through rule making. Other rules to expand vaccine mandates are pending in Wisconsin and Wyoming.

In six states, there were bills filed trying to mandate use of the HPV vaccine: Connecticut (HB 7199), Florida (HB 245 and SB 356), Illinois (SB 1659), Massachusetts (pending S 1264), New Jersey (pending A 1847) and New York (S 298A).

Because the Hawaii governor approved a rule requiring all children to receive ACIP-recommended vaccines to attend school, HPV vaccine will be mandated in Hawaii unless families can get the legislature in 2020 to repeal this rule.

There were four bills filed in two states to mandate meningococcal vaccines. In New Jersey, bills A 1991 and S 941 to mandate meningococcal vaccines for attendance at four-year colleges are still pending.

In Texas, there were two useless bills to mandate meningococcal vaccines (HB 4068 and SB 1292) that died. Texas already requires meningococcal vaccines for seventh grade and college and legislators and families left the hearing scratching their heads over this bizarre request. Failed HB 1312 out of Colorado attempted to mandate meningococcal vaccines, as well as vaccines for hepatitis A and rotavirus.

A vaccine mandate for first responders in Texas (SB 830) was fortunately killed. NVIC opposes all adult mandates as a condition for employment. Vaccines are already available to those who want them.

A very odd and unreasonable bill in Texas (HB 3390) would have required temporary caregivers to have all of their pets vaccinated. While the bill did ultimately pass, the bill sponsor fortunately responded to citizen requests and removed the erroneous pet vaccine requirement from the bill.

Restricting Vaccine Mandates — NVIC supported 18 bills in 13 states that would have restricted vaccine mandates. Unfortunately, none of these passed. Seven bills were filed in Maine, Minnesota, Mississippi, Ohio, Oklahoma and Oregon to protect employees who want to refuse vaccination requirements.

Hawaii SB 925 and SB 926 and Oklahoma HB 1112 would have prohibited new vaccine mandates to be issued by agency rule making. While these bills failed to pass, passage of a similar bill in Hawaii next session could help undo the damage of the new mandates and exemption restriction that was passed by Hawaii Rule HAR 11-157.

Michigan (HB 4711) and Montana (HB 574) set their sights on prohibiting a requirement that foster care families vaccinate their families. While the Montana bill died, the Michigan bill is still pending and support could help tip this good bill over the edge to pass.

Connecticut, Idaho, Montana, Texas and Washington had bills filed to reject vaccine mandates for certain diseases or ingredients. Legislators are increasingly hearing concerns over the exploding vaccine schedule and controversial ingredients. Hopefully, next session there will be more progress on bills restricting or eliminating vaccine mandates.

Vaccine Tracking and Reporting (27 Bills) — Forced inclusion, forced reporting and OPT-OUT electronic vaccine tracking registries and enforcement systems continue to threaten the medical privacy of citizens and their legal right to delay or decline one or more federally recommended vaccines without being subjected to harassment or punishment.

The 2019 legislative session included 27 bills in this category that NVICAP posted and tracked, and nine of these bad bills passed. Louisiana (SB 169) and Rhode Island (H 5541A and S 676A) both passed bills to require the tracking of adult vaccination status.

The new law in Louisiana, already in effect as of June 11, 2019, is bad because it removes the existing requirement for consent before vaccine records can be shared, and it eliminates the current practice of purging of registry records after age 21.

It is a forced inclusion vaccine tracking system. Louisiana's vaccine tracking system is now cradle to grave for everyone who lives there. You cannot opt-out of being tracked by the Louisiana health department; you can only opt-out of data sharing by the department — but the department will know everyone's vaccination status under this law.

In a bright spot, forced adult vaccine tracking was defeated in New York (A 6847 and S 4994) thanks to many families in New York following NVIC's action alert to contact committee members and their own legislators to stop A 6487 in the Assembly Health Committee.

Indiana passed controversial SB 228, which allows the state department to release information in the immunization data registry to the Centers for Disease Control and Prevention. Indiana's Immunization Registry Data Exclusion Request Form can be found here.

Florida passed HB 213, which took an already expansive and intrusive electronic vaccine tracking system, Florida Shots, and made it even worse. Health care practitioners are now required to "report" to the vaccine tracking registry, which allows their performance of vaccinating everyone to be monitored by the health department.

It is important to take note of the fact that the new law permits confidential electronic health records held by your doctor about you to be data mined by the health department without your knowledge or consent, as HB 213 gave the green light for "the upload of data from existing automated systems."

Legislators were misled by bill supporters with the false notion that families can "opt-out" of tracking and, yet, the law still requires the sham of the state opt-out forms to be submitted to the health department. In other words, those who don't want to be tracked by the state have to send forms to the state requesting to opt-out, but still will be tracked by the health department as a registry refuser.

HB 213 brought adults participating in higher education into the vaccine tracking system too. Also, the practice of Florida Shots providing every child born in the state with a registry file continues. NVIC is advocating for legislators to come back next session and change the registry to a true opt-in system.

NVIC is urging the Florida legislature to fix this by prohibiting health care providers from releasing vaccination records and related personal information to the health department unless the patient or parent or guardian has willingly given opt-in written informed consent for the release of their records from their provider and agrees to inclusion in the tracking system.

Strong opposition to mandatory inclusion and assumed consent opt-out vaccine tracking systems is needed. Reaching a 100% vaccine compliance rate by all children and adults is the goal of these electronic tracking systems.

The Florida registry is already being used as an enforcement tool to target families not fully vaccinating with calls, letters and even home visits as evidenced by the Community Guide:

"Using the Florida Shots Registry, which tracks each resident's vaccinations, clinic staff identified infants and toddlers who were due for, or had missed, vaccinations… For children behind on their immunization series, clinic staff reached out to parents through phone calls, letters, and home visits encouraging them to schedule 'catch-up' vaccinations."

At what point will this information on residents of Florida be held without consent by the health department and used in the future to order forced vaccinations as the mayor in New York City did this year? The groundwork is already done as the health department has recorded ALL religious exemptions into the registry, even if a family has opted out of tracking!

"All religious exemptions in Florida as of December 17, 2011, are registered in Florida SHOTS." They use a child's home address information to produce a map of where our children with religious exemptions live in Florida. Maps such as these were released and promoted by the media to fuel the removal of the personal belief exemption in California.

Families who are delaying or declining vaccination are being thrown out of pediatric practices throughout the state of Florida because the American Academy of Pediatrics and other trade associations have condemned vaccine exemptions and are lobbying for their removal.

Due to the registry reporting requirements for health care practitioners under HB 213, access to care will get worse for families because doctors who still treat children who aren't fully vaccinated will be under more pressure to deny medical care to children whose parents decline to give them every CDC-recommended vaccination.

HMOs are already trading records back and forth with the Florida Shots Registry and monitoring the performance of individual doctors on fully vaccinating their patients:

"Our data exchange technology allows HMOs to instantly match their records to those already entered in the Florida SHOTS. In turn, any data not already entered in Florida SHOTS will be uploaded and any data not already in the hands of the HMO will be forwarded on …

Data exchange offers a quick, easy way for health maintenance organizations (HMOs) to determine immunization coverage levels within participating provider practices."

Citizens in every state need to learn from what has happened in Florida and stop it from happening in their state. Google/YouTube is being fined $170 million for violating federal privacy laws and collecting data on children without parental consent, and it is time for state legislators to repeal assumed consent opt-out and forced inclusion, intrusive electronic vaccine tracking systems that are also collecting and storing data on minor children without parental consent.

Maryland passed a bill (HB 316) to require health care providers to report the vaccination status of patients to the state's vaccine tracking registry. Oregon's dentists, who were recently authorized to give vaccines through the passage of HB 2220, must also report to the state's registry.

In Texas, first responders and EMS applicants have been drafted into the vaccine tracking system through the passage of HB 1256 and HB 1418. While Texas' registry is an opt-in system by law, these industries need to be watched to make sure they don't start to discriminate against potential and current employees based on vaccination status information contained in the registry.

Fortunately, legislators in both Texas (SB 1427) and Montana (HB 596) killed bills that would eliminate the current legal requirement to obtain opt-in consent to vaccine tracking. In addition, two bills died in Alabama (HB 522 and SB 256), which had tried to mandate that all vaccine providers put all vaccines given to everyone, past and present, into their vaccine tracking system.

NVIC recently submitted comments to Wyoming to oppose a proposed rule that would remove a section entitled "Patient Consent" for the Wyoming Immunization Information System, which prevents the health department from retaining individually identifiable information in the state vaccine tracking system for someone who has opted-out using a Use and Disclosure Restriction (F-12) form.

The health department is using the rule making process to try to change the vaccine registry so that the department will retain a registry file on everyone — even if they deny consent for the registry — but immunization information still will be maintained in an "aggregate format."

Legislators should not be fooled by government agency bureaucrats hiding behind the guise of security and privacy from deidentified data, as computer scientists have developed an algorithm that can pick out almost any American in databases supposedly stripped of personal information.

Scientists at Imperial College London and Université Catholique de Louvain in Belgium reported in the journal Nature Communications that they had devised a computer algorithm that can identify 99.98% of Americans from almost any available data set with as few as 15 attributes, such as gender, ZIP code or marital status. The potential for abuse from these electronic vaccine tracking systems for intended and unintended use of the data they contain is real.

Wyoming should not be storing information on anyone who does not want to be in the registry. NVIC requested a public hearing be held and, at the time of this writing, the deadline for the health department's reply has passed and they have not responded as required. Please watch the alert on the NVIC Advocacy Portal for updates.

Colorado, New York, Iowa, Montana and Texas had failed bills that NVIC opposed which had attempted to expand vaccine tracking, remove required consent and force reporting to the electronic vaccine tracking registries.

Vaccines (27 Bills)

Authorizing More Professions to Administer More Vaccines — More states continue to authorize more pharmacists to expand services to include the administration of vaccines to younger children. In 2019, both Arkansas (HB 1278) and Montana (HB 231) passed bills to allow pharmacists to vaccinate children as young as 7 and older.

Texas fortunately killed a bill (SB 1813) that would have allowed pharmacists to administer vaccines to children 7 years and older without a required doctor-patient relationship. Watch testimony against HB 3458 by NVIC director of advocacy Dawn Richardson at 1:20:35. This was one instance this past session where doctors and NVIC both opposed the same bill, but for very different reasons.

2019 also revealed a push to expand vaccine administrators to other professions outside of pharmacists. Oregon passed a bill (HB 2220) to allow dentists to administer vaccines.

Ohio's pending bill (SB 178) would allow podiatrists to administer flu vaccines to anyone 7 years old and older, and there are still opportunities to oppose SB 178. Wyoming had a failed bill, SF 55, that would have allowed the state health officer to authorize optometrists to administer vaccines. Everybody wants a piece of the almost $18 billion dollar U.S. vaccine market in 2020.

Pennsylvania has pending bills (HB 91 and SB 274) still deserving opposition which are attempting to clear the way for pharmacists to vaccinate children as young as 9 years old. The most concerning bills still pending are in Wisconsin (AB 137 and SB 110), which would allow pharmacists to administer vaccines to children under 6 years old.

Requiring Vaccine Promotion/Marketing — While the most active category in expansion of vaccine-related state legislation in 2018 was bills proposing to legally require the marketing and promotion of specific vaccines, this area in 2019 has significantly decreased.

Unlike legal requirements to be vaccinated, these mandates require either public or private businesses to advertise or promote vaccine use. These vaccine promotion messages tend to adopt a one-size-fits-all approach and rarely do vaccine marketing materials contain information about vaccine risks or how to prevent vaccine injuries.

Iowa broke new ground by passing a bill (HSB 86) to establish tax breaks by creating a bioscience development corporation as nonprofit for tax purposes to funnel money into the development of several areas including vaccines and immunotherapeutics.

Oregon, as of July 15, 2019, now requires (SB 488B) correctional facilities to offer flu vaccines to each inmate and prisoner. Other bills, which proposed to mandate vaccine promotion and marketing by an entity other than the drug company itself, failed, as they should have, in Connecticut, Indiana and Texas.

New Jersey still has pending bills to require health care facilities to implement flu vaccination programs for employees (A 1576), and to push a public awareness campaign to promote vaccines (A 5402 and S 4008). Please continue to ask legislators in New Jersey to oppose these bills.

Comparing Recent Sessions to 2019 — Two-hundred-twenty-one bills and five sets of rules filed in state legislatures in 2019 represent the most proposed vaccine-related measures NVIC has recorded in the history of the NVIC Advocacy Portal. The number of states proposing bills that affected NVIC's mission has increased since last year, from 36 states to 40 states and the District of Columbia.

It is important to note that some of the increases in numbers of vaccine-related bills filed can be attributed to the fact that the legislatures in four states — Montana, Nevada, North Dakota and Texas — meet biannually to consider new bills and do not hold a legislative session in even years.

In 2019, 39 of the 221 bills filed were in Montana (9), Nevada (1) and Texas (29). Regardless, this is still the most active year ever. NVIC correctly predicted in NVIC's 2018 Annual Report on U.S. State Vaccine Legislation that we would see more vaccine-related bills introduced in 2019 than we have ever seen since the NVICAP was launched in 2010.

total vaccine related bills

While there were more bills filed that NVIC opposed (137) than in any other legislative session, there were also more bills filed that NVIC supported than in any other session (77).

There were many more positive bills filed in 2019 than any other year to expand vaccine exemptions and informed consent rights, to restrict addition of new vaccine mandates, to disallow adding vaccine mandates by health department rule making, to require doctors and other vaccine providers to report vaccine reactions, and to prohibit abuse claims, custody restrictions or discrimination for vaccine refusal.

nvicap supported legislation increases

Enlightened legislators not only are listening to concerned constituents in greater numbers, but many more are continuing to largely resist aggressive lobbying efforts by the vaccine industry, medical trade and other groups whose positions and profits benefit from laws that force children and adults to use every vaccine sold by pharmaceutical companies and recommended by public health officials.

Only 18 bad vaccine bills passed out of the 137 that NVIC opposed in the 2019 legislative session. While the bills to remove or restrict vaccine exemptions got the bulk of the sensationalized press, only three of the 22 bills across 17 states to eliminate vaccine exemptions passed, and two of the 18 bills attempting to restrict exemptions passed.

Individual citizen involvement in the legislative process, through personal communications and education of legislators, continues year after year to make a significant impact on the outcomes of vaccine-related bills in state legislatures. NVIC predicts that the increased attack on exemptions and informed consent rights this year will drive even more U.S. citizens to get more involved in the legislative process at every level in the years to come.

vaccine related legislation trends

What Can You Do?

NVIC expects that the vaccine industry will step up lobbying efforts to restrict or remove vaccine exemptions in 2020 since so many of their bills failed. Please become a registered user of the NVIC Advocacy Portal and check in often to learn about ways to personally educate your legislators when vaccine bills that affect your rights are moving in your state.

Please encourage your family and all of your friends to do the same. Clearly, your efforts are making a much more significant difference than the media and those pushing "no exceptions" forced vaccination policies and laws are willing to admit, and your active participation is vital to protecting informed consent rights and vaccine choices in America.

If you see inaccurate information in the media, please take the time to respond by making a constructive comment online. You can also email the journalist or call the media outlet and provide accurate, well-referenced diseases and vaccines information and accurate state vaccine law information, which you can find on our website NVIC.org.

NVIC's illustrated and fully referenced A Guide to Reforming Vaccine Policy & Law" is another good vaccine education tool for legislators and friends and family, too.

Yes, the challenges are great, but so are the opportunities to educate and empower legislators and residents of every state to defend vaccine freedom of choice. NVIC is committed to continuing to make that happen and we look forward to working with you through the NVIC Advocacy Portal to help you protect vaccine informed consent rights in your state in 2020 and beyond.