An immunization-related bill (AB123) was recently introduced in the Assembly Education Committee by Assemblywoman Connie Munk. We have the ABCs of what this bill is about, why it’s necessary, and how it may impact you, your child, and your community. We encourage you to follow this post for updates throughout the Legislative Session. 

The quick and simple summary:

• AB123 would require schools to submit to the Nevada Division of Public and Behavioral Health (DPBH) a de-identified list (no identifying information) of the number of students with religious and medical exemptions each year.
• In the event of an outbreak, AB123 would require schools to report the exempt student’s information to the necessary local, state, and federal health agencies as determined by the level of response needed.
• AB123 would require religious and medical exemptions be submitted on a form provided by DPBH, and filed annually.

The health, safety, and economic impact of vaccines are why all states require immunizations to be up-to-date for public and private school attendance. Nevada state law not only establishes religious and medical exemptions for school vaccination requirements, but also establishes the implications of an exemption in the event of an outbreak. Current NRS requires the exact number of pupils who have completed the required immunizations to be self-reported annually by both schools and child care/accommodation facilities to DPBH by December 31. AB123 will reduce the burden Nevada has placed on schools to manage this process without a standard process or resources to assist.

With an estimated 800 schools in Nevada, the capacity for error and interpretation under current NRS is immense. Schools with low immunization rates are at increased risk for vaccine preventable disease, and the knowledge of those schools is helpful for public health epidemiologists to predict where an outbreak may occur. In order to effectively prevent and prepare, DPBH needs a de-identified list of exemption totals on an annual basis along with their immunization rates; and accurate totals are dependent on standard forms used consistently by all schools and filed annually. 

AB123 aims to ensure compliance with Nevada law for school immunization requirements – keeping Nevada’s students in their seats learning instead of sick at home.

A. What are the benefits of AB123?

• Enhanced communication between health authorities, including DPBH, local health districts, and school districts.
• Standardized process for religious and medical exemptions for schools to utilize, making it easier for the schools to comply with the law and saves personnel time. For public schools, this process would be integrated with Infinite Campus.
• Areas at high risk for vaccine preventable disease would be identified before an outbreak occurred, helping keep kids safe and healthy at school.
• Schools would have a documented process to ensure children’s immunization status is properly collected, reported, and tracked in a timely manner.
• Effectively documenting student immunization data helps prevent missed days of school due to exclusion notices.
• Follows best practices for exemption forms to include annual renewal, risks of disease, and acknowledgment of exclusion during an outbreak.

B. Who does AB123 help the most?

• School personnel will benefit from a standard process that ensures fairness to all families, saves staff time, and removes the burden placed on them of deciding whether or not an exemption statement is valid. This frees up time for school nurses to focus on other duties.
• Public health will receive timely data when responding to vaccine preventable disease outbreaks, as it ensures those students who are unvaccinated are excluded from school as soon as possible.
• Licensed physicians and APRNs will have a standard form to assist in granting a medical exemption based on CDC recognized contraindications for immunization, and whether the exemption is temporary or permanent. Requiring an annual filing follows the American Academy of Pediatrics (AAP) recommendation of an annual well visit.
• AB123 will save Nevada money. Outbreaks require a huge investment of public health staff and financial resources to control and contain once they have begun. The 2017 Minnesota measles outbreak cost public health an estimated $2.3 million to contain. These costs do not include the amounts incurred by private insurance, Medicaid, or by families due to lost days of work or ongoing care, and outbreak-response costs to schools and hospitals.

C. Why does private information need to be shared?

• There are explicit statements under the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA) that allow for information sharing of student and patient information during an outbreak, and this sharing has already occurred with previous outbreaks in Nevada schools. AB123 just reinforces the process necessary for information sharing in an outbreak.
• These privacy statements also apply to all disease outbreaks - not just those that are vaccine preventable, such as norovirus. Schools regularly battle norovirus, so chances are high many parents have already experienced this sharing of information.
• Schools and public health also work together to identify trends in chronic diseases, student injuries, childhood obesity, and more. This information may be shared through de-identified lists, or in some cases, may be shared with parental consent.

D. My children are vaccinated. How does this benefit me?

• The majority of Nevada children are vaccinated, but when there are pockets of low vaccination rates – everyone is at risk.
• A number of vaccine-preventable diseases are life-threatening to children who are too young to be vaccinated or medically vulnerable, such as those undergoing cancer treatment. Even if a child is vaccinated, they may be temporarily be at risk because of their medical condition.
• No vaccine provides 100% protection against the consequences of a vaccine-preventable disease (VPD) outbreak. It’s like a carseat – it provides better protection in case of an accident, but you still do everything you can to avoid getting into a car accident in the first place.
• Knowing school vaccination rates allows parents to understand the level of risk of the environments in which they place their children and empowers them to make informed choices.
• Children have the right to attend school in a safe environment, and it’s vital that immunization rates are high to ensure the community immunity necessary to prevent outbreaks.
• The National Parent-Teacher Association supports the efforts of schools to enforce immunization laws, and advocates for certification of vaccinations as a condition of entry into schools.

You can submit your opinion on this bill and other Nevada bills, as its important for legislators to hear from their constituents. Nevada is facing both public health and education funding challenges, and AB123 aims to help avert the disease and economic crisis happening in other states like Washington – from happening in our communities.