May 24, 2023
To: New Jersey Department of Health
Re: Comments on “Proposed Rule Revisions to NJAC 8:57”
The Association of American Physicians and Surgeons (AAPS), a professional association of physicians in all types of practices and specialties across the United States, welcomes the opportunity to provide comments on potential changes to New Jersey Administrative Code (N.J.A.C.) Title 8 Chapter 57.
As far as we can determine, no specific changes have been formally released; however, the publicly available slides from a “Request for Stakeholder Feedback” presentation dated April 2023 indicate that the New Jersey Department of Health (NJDOH) is considering a number of concerning provisions AAPS would oppose if they are introduced.
Slide 3 (N.J.A.C. 8:57-1 Scope & Authority) indicates the NJDOH is considering expanding both the scope of entities required to report to the department and its ability to access “public or private places and records/things at these premises.” AAPS objects to such expansions. Abuse of power by public health authorities during the COVID-19 pandemic demonstrates that, instead of handing more power to agencies like the NJDOH, the public needs increased protections from agency overreach.
Slides 4 and 5 (N.J.A.C. 8:57-1 Confidentiality & Data Release / Public Health Investigation) address increasing NJDOH access to and reporting of “Personal Identifying Information (PII).” It is the position of AAPS that patients must retain control over who is allowed access to their medical information and how it is used. The AAPS Patient Bill of Rights, adopted by our organization in 1995, states that patients must be “treated confidentially, with access to their records limited to those involved in their care or designated by the patient.” Protecting this information from misuse is not a theoretical concern when individuals are being denied the ability to work, travel, or attend school, based on information in their medical record. These policy missteps have consequences. For example, as the NY Times reports, “Math, reading and history scores from the past three years show that students learned far less during the pandemic than was typical in previous years.”
Slide 6 (N.J.A.C. 8:57-1 Reportable Disease List) indicates that the Department wishes to grant itself the ability to designate diseases as publicly reportable. AAPS objects to broadening the NJDOH authority in this manner, due to the existing and potential future misuse of public health rules as a tool for abrogating the civil rights of patients without adequate due process or other safeguards in place.
Slide 8 (N.J.A.C. 8:57-3 NJ Immunization Information System) appears to propose expanding reporting into the New Jersey Immunization Information System (NJIIS). Currently medical clinicians that provide vaccination to children “less than seven years of age” are required to submit reports to the NJIIS. NJDOH suggests “increasing the upper age limit.” Instead of broadening the violation of patients’ and parents’ rights to medical privacy, AAPS urges the Department to consider whether this registry is needed at all, given the potential for misuse and abuse, in addition to lack of public benefit.
Slide 9 (N.J.A.C. 8:57-4 Immunization of Pupils in School) demonstrates a desire of NJDOH to expand school vaccination requirements in a number of aspects. While the Department says it does not intend to add additional vaccines to the list of shots required to attend school, the top of slide 9 states a desire to, “align immunization requirements … with the current ACIP recommendations.” A study of national vaccine policy published by AAPS, exposes the secret process stacked with special interests that decides the vaccine policies of this entity. “Members of the [Center for Disease Control and Prevention] Advisory Committee on Immunization Practices (ACIP) … are often nominated by the drug companies and have substantial financial ties to the drug companies….Members are forbidden to publicly discuss what happens during closed portions of the meetings. The precise scientific, medical, and political bases for the vaccine recommendations are never revealed. Thus the drug companies and CDC have strong incentives to expand immunization programs,” writes Roger Schlafly, Ph.D. in the journal of AAPS.
ACIP recommendations include shots like COVID-19 and HPV currently not on the list of NJ mandates. In an October 19, 2022 letter to ACIP, AAPS writes: “If the goal of the CDC is to protect children, there is no rational basis for recommending that kids receive a vaccination for COVID. To the contrary, there is myriad objective evidence contraindicating the shots.” Regarding HPV vaccine mandates, AAPS has since 2007 maintained that “there is no public-health purpose for mandating HPV vaccine for schoolchildren.”
In fact, instead of expanding mandates, the NJDOH should impose a moratorium on all mandated shots as recommended by AAPS in a resolution passed by our members in 2000. One current vaccine mandated by NJDOH that deserves particular scrutiny is the requirement that children receive a Hepatitis B vaccination in order to attend school. “Too few children contract the disease to justify exposing all children to the risk of adverse vaccine reactions,” states AAPS Executive Director, Dr. Jane Orient. She continues, “In the United States, hepatitis B is primarily an adult disease, and risk is highly dependent on lifestyle. Risk factors include: multiple sex partners, drug abuse, an occupation involving frequent exposure to blood, or having a hepatitis-B infected mother. The disease is not spread by casual contact.”
Slide 11 (N.J.A.C. 8:57-6 Higher Education Immunization), suggests the NJDOH favors requiring meningococcal vaccines for college students, as recommended by the ACIP. In addition to reasons stated above for avoiding ACIP recommendations and mandates, AAPS analysis specific to meningococcal vaccination, finds that the risks of adverse reaction from a shot that may not even prevent infection from this disease of extremely low prevalence, do not likely outweigh any potential benefits.
Thank you again for the opportunity to share the feedback of practicing physicians on these issues of crucial importance to all citizens, parents, children and patients in New Jersey. It is incumbent on the agency to fully disclose any policy proposals and allow rigorous public debate and input before proceeding with increasing the department’s authority. In conclusion, we urge NJDOH to avoid imposing new mandates and policies that infringe on patient autonomy and privacy rights, particularly when the ability to simply participate in society hinges on power improperly and unjustly wielded by public health authorities. Specifically, we object to any new vaccine mandates at this time, while medical and religious exemptions are not fully and broadly available.
