New Hampshire’s Immunization System - opt in or opt out

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TO:  Chief Medical Officers, Chief Nursing Officers, Chief Information Officers, Health Information Management Directors & Compliance

From:  NHIIS Support Team


On or before July 1, 2023, healthcare providers must give patients the opportunity to opt-in or opt-out of having their immunization records shared with New Hampshire’s Immunization System.


New Hampshire was the last state in the country to adopt an immunization registry.  NH’s immunization registry became operational during the last couple of years, starting with COVID-19 vaccines and then with all state-supplied vaccines (such as childhood vaccines).  Currently, patients’ immunization information is sent to the New Hampshire Immunization Information System (NHIIS), also known as the NH immunization registry, unless a patient requests to opt-out.


The statute that governs the operations of the NHIIS was updated last year to require that patients be given the opportunity to opt-in or opt-out of having their immunization records shared with the NHIIS. That change becomes effective on 7/1/23. With the statute change, patients must be allowed to explicitly choose an opt in or opt out for their immunization information to be entered into the NHIIS. 


NH DHHS was supposed to promulgate administrative rules that would provide details to health care providers on how to implement the law change.  Unfortunately, NH DHHS is delayed in finalizing those rules and the rules won’t be available before the implementation date of 7/1/23. In lieu of having administrative rules in place, NH DHHS recently provided the following guidance information for health care providers:


Greetings Vaccine Managers/Providers,

Per RSA 141-C:20-f all NHIIS participating vaccinating providers will be required to give each patient, or the patient's parent or guardian if the patient is a minor, the opportunity to opt-out or opt-in to the immunization registry effective July 1, 2023.  As explicit consent will be required prior to entering any patient’s personal data into the registry, providers should no longer use the "Choose not to Participate in the New Hampshire Immunization/Vaccination Registry" form as this form does not provide an option for the patient to Opt-in to the NHIIS. 

Providers will need to ensure organizational procedures are set in place to obtain and document the patients decision to Opt-In or Opt-Out along with their explicit written or electronic consent if Opting In.  This may be accomplished by utilizing this sample “Interim Opt-In Opt-Out” form or by developing another internal mechanism to ensure compliance with RSA 141-C:20-f.

Do not hesitate to reach out to us with questions.


NHIIS Support Team
Immunization Program
Bureau of Infectious Disease Control     
Dept. of Health & Human Services
29 Hazen Drive       
Concord, NH  03301-6504
Phone: 603-271-4028
Fax: 603-271-3850