Ian Watt, director of the Division of Public Health, told the oversight committee on Nov. 21 that New Hampshire will continue to maintain access to safe and effective vaccination for residents through state programs and local providers. Watt reviewed recent federal changes and the state's approach to keeping vaccines available.

Watt said the Centers for Disease Control and Prevention revised guidance for the measles-mumps-rubella and varicella series: the combined MMRV vaccine is no longer recommended for the first dose in children under 4 because of a higher risk of febrile seizures; the combined vaccine remains recommended for the second dose. The director said roughly 15% of children previously received a combined MMRV as the first dose.

Committee members asked whether federal changes change state school mandates or availability. Watt said those respiratory-virus guidance items issued in September are not school mandates and that statutory exemptions for school-required vaccines (including MMR) remain in place; he also said federal programs such as the Vaccines for Children program continue to underpin vaccine availability and funding.

Patricia Tilley, associate commissioner, added that funding through partnerships with commercial insurers for childhood vaccines remains intact at present. Members raised questions about whether mandates differ for charter schools and about access and funding; Watt and Tilley said supply and federal funding mechanisms have not changed and that access via providers and pharmacies remains available.

Watt said the division will monitor federal developments, continue to review evidence-based guidance and prioritize access for vulnerable populations, including seniors, pregnant people and immunocompromised residents.