REPORT TITLE:
Hepatitis A Immunization


DESCRIPTION:
Requires immunizing children against hepatitis A to enter all
schools.  Allows DOH to require immunization for all under
certain circumstances.  Conditions required immunizations on
availability of federal funds.  Requires DOH report.  Effective
07/01/01.  Repealed on 06/30/05.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        
THE SENATE                              S.B. NO.           2462
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO IMMUNIZATIONS.



BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  The legislature finds and declares:
 
 2      (1)  Hepatitis A is a disease which, as recently as 1997,
 
 3           was infecting Hawaii residents at a rate of 12.40 per
 
 4           100,000 ranking the State fifteenth in the nation;
 
 5      (2)  Hepatitis A is a serious viral infection of the liver
 
 6           that is highly contagious and is spread from person to
 
 7           person either directly or via contaminated substances
 
 8           such as food, water, toys, surfaces, etc.;
 
 9      (3)  Hepatitis A is a disease which is totally preventable
 
10           through the use of a vaccine;
 
11      (4)  The Centers for Disease Control, the American Academy
 
12           of Pediatrics, and the Academy of Family Physicians all
 
13           recommend childhood immunization for high endemic
 
14           areas;
 
15      (5)  The disease is cyclical, therefore, even though Hawaii
 
16           may be experiencing a temporary lull in infection
 
17           rates, the disease has, as recently as December 1996,
 
18           occurred in more than thirty per 100,000 -- three times
 
19           the national average;
 

 
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 1      (6)  The cost of treating hepatitis A ranges from $433 for
 
 2           children to $2,549 per adult;
 
 3      (7)  An outbreak of hepatitis A at a tourist location has a
 
 4           tremendously negative impact, often leading to the
 
 5           closing of the businesses involved in the outbreak;
 
 6      (8)  The federal Vaccines for Children funding program makes
 
 7           the vaccine free to all persons from age two to
 
 8           eighteen who reside in states and communities or
 
 9           counties where the average annual hepatitis rate during
 
10           the period 1987-1997 was at least ten in 100,000
 
11           population;
 
12      (9)  The only way to truly eliminate the disease from Hawaii
 
13           is to vaccinate all residents.  Given the economic cost
 
14           of such a program, this Act focuses on children, among
 
15           whom the disease is easily spread; and
 
16     (10)  The highest rates of infection, at thirty-three per
 
17           cent, occur in children aged five to fourteen, who then
 
18           become a major source of transmission.
 
19      SECTION 2.  Section 325-32, Hawaii Revised Statutes, is
 
20 amended to read as follows:
 
21      "§325-32  Immunization against infectious diseases.  (a)
 
22 The department of health may adopt rules requiring and governing
 
23 immunization against:
 

 
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 1      (1)  [typhoid,] Typhoid fever;
 
 2      (2)  [pertussis,] Pertussis (whooping cough);
 
 3      (3)  [diphtheria,] Diphtheria;
 
 4      (4)  [tetanus,] Tetanus;
 
 5      (5)  [poliomyelitis,] Poliomyelitis;
 
 6      (6)  [measles,] Measles;
 
 7      (7)  [mumps,] Mumps;
 
 8      (8)  [hepatitis B,] Hepatitis B;
 
 9      (9)  [rubella,] Rubella;
 
10     (10)  [haemophilus] Haemophilus influenzae type B[,]; and
 
11     (11)  [any] Any other communicable disease, if a suitable
 
12           immunizing agent is available for the disease and a
 
13           need for immunization against it exists within the
 
14           State.
 
15      (b)  In any county where:
 
16      (1)  The department determines action is warranted to
 
17           protect the public health against hepatitis A; or
 
18      (2)  The rate of incidence of hepatitis A is greater than
 
19           the national average of ten in one hundred thousand,
 
20 the department may require immunization against hepatitis A.
 
21 This subsection shall be implemented only if the Centers for
 
22 Disease Control certifies federal Vaccine for Children funds are
 
23 available for that purpose.
 

 
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 1      (c)  The department may also provide vaccines and other
 
 2 immunizing agents to private and public health care providers for
 
 3 administration to the general public."
 
 4      SECTION 3.  Section 302A-1154, Hawaii Revised Statutes, is
 
 5 amended to read as follows:
 
 6      "§302A-1154  Immunization upon entering school; tuberculosis
 
 7 clearance[.]; hepatitis A.  (a)  No child shall attend any school
 
 8 in the State unless the child presents to the appropriate school
 
 9 official certification from a licensed physician or advanced
 
10 practice registered nurse stating that the child has received
 
11 immunizations against communicable diseases as required by the
 
12 department of health[.] pursuant to section 325-32.
 
13      (b)  No child shall be admitted to attend any school for the
 
14 first time in the State unless the child presents to the
 
15 appropriate school official certification from a licensed
 
16 physician, advanced practice registered nurse, or other
 
17 authorized personnel stating the child has received a tuberculin
 
18 test or x-ray and is free from tuberculosis in a communicable
 
19 form.
 
20      (c)  The requirement for immunization against hepatitis A
 
21 pursuant to this section and section 325-32 shall be implemented
 
22 only if the Centers for Disease Control certifies federal Vaccine
 
23 for Children Funds are available for that purpose."
 

 
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 1      SECTION 4.  The department of health shall report to the
 
 2 legislature no later than twenty days prior to the convening of
 
 3 the regular session of 2005 regarding the following:
 
 4      (1)  The effectiveness of the immunization of children
 
 5           against hepatitis A;
 
 6      (2)  Morbidity and mortality statistics on hepatitis A by
 
 7           county;
 
 8      (3)  A cost benefit analysis for immunizing children against
 
 9           hepatitis A; and
 
10      (4)  Policy recommendations for immunizations and other
 
11           prevention strategies for hepatitis A in Hawaii.
 
12      SECTION 5.  The department, no later than July 1, 2000,
 
13 shall request certification from the Centers for Disease Control
 
14 that federal Vaccine for Children funds are available for the
 
15 purposes of this Act.
 
16      SECTION 6.  Statutory material to be repealed is bracketed.
 
17 New statutory material is underscored.
 
18      SECTION 7.  This Act shall take effect upon approval except
 
19 that:
 
20      (1)  Section 5 shall take effect on July 1, 2001; and
 
21      (2)  On June 30, 2005, sections 2 and 3 of this Act are
 
22           repealed and reenacted in the form in which they read
 

 
 
 
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 1           on the day before the approval of this Act.
 
 2 
 
 3                           INTRODUCED BY:  _______________________