CONCORD — New Hampshire is on its way to building a registry of who has been vaccinated or immunized — the last state in the country to do so — after the Executive Council approved a key contract Wednesday.

In a 5-0 vote, the body approved a $550,000 contract with a consulting firm to help start building up a new “Immunization Information System” that would allow the state to both track the vaccines that it purchases and register those who have received vaccines.

New Hampshire already has a system to track vaccine purchases. But currently the state does not keep records of those who have been immunized. The new system would be “opt-out,” giving Granite State residents a chance to block records.

“We don’t have the registry component set up, but we’re obviously looking to expand that component up due to all of the benefits it provides to the citizens of New Hampshire,” said Dr. Beth Daly, chief of the Bureau of Infectious Disease Control.

State officials have been attempting to create a system since 1998, when the Legislature first passed a law, but funding hitches and privacy concerns have slowed the proposal’s progress. Still, the latest attempt to use that grant has attracted strong criticism from privacy advocates and anti-vaccine advocates, many of whom packed the Executive Council chambers earlier this year to speak against the effort.

Facing a deluge of emails and calls from constituents, executive councilors voted to table the contract item earlier this year. Now, midway through pandemic, time is running out. The CDC funding will expire if no action is taken to encumber the funds by the end of June, Department of Health and Human Services officials said Wednesday.

“I think the people of New Hampshire have had the opportunity to speak on this,” said Councilor Russell Prescott, a Kingston Republican. “Even though I do not have the same policy in my heart — my policy would be to opt-in — that is not the policy of our state, and I’m not going to stand in the way of the policy of our state.”

The rulemaking process became an early hang-up. Lawmakers struggled to find an approach to a registry that would uphold the state’s tradition of privacy.

Then the state faced a bigger problem: It couldn’t find the funding.

That delay caused the original rules set by lawmakers to expire in 2007. In 2013, they identified funding to find its first software vendor. It wasn’t until 2016 that the effort to rewrite the rules was taken up again.

The Department of Health and Human Services is now working with a new $1.5 million in grant funding from the Centers for Disease Control and Prevention to start up the system. Councilors ultimately allowed the first piece of funding to move forward, but not before posing a lengthy series of questions to the department.

Prescott invoked the state’s recent passage of a constitutional amendment to protect privacy, asking Daly and the department how it planned to protect those who didn’t want medical information shared.

Daly noted that the registry is “opt-out,” meaning that while those who become immunized will automatically be entered into the system, they can remove themselves from the records immediately or at any time.

The system will not collect general medical information; records will be limited to immunizations.

Health care providers are responsible for informing patients of their rights to opt out of the registry, Daly said. Patients will be told in person and will receive letters informing them of their rights, she said.

Participants may also choose to opt back in if they wish.

The system will be separated into components, Daly added. One half will track the purchases by the state of vaccines and immunization materials. The other will keep track of immunization history.

Having the registry system “would involve us being able to monitor the immunization rate,” Daly said. “It provides better data for our health care providers to be able to identify their patients who are due for vaccines.”

Throughout nearly an hour of questioning Wednesday, councilors alluded to passionate responses they had heard from constituents over the issue. Councilor Deb Pignatelli, a Nashua Democrat, pointed to the multitudes “who have emailed me and have left thoughtful phone messages on my machine.”

“I hope to get back to many of you, at least the ones that didn’t threaten me personally, and help alleviate some of your fears and concerns about this,” she said. “I think there is a lot of misinformation out there. Right now I am prepared to vote in favor of this item.”

In voting for the $550,000 contract, councilors gave the green light to HLN Consulting, a California company, to begin laying the groundwork for the creation of the system. HLN was chosen because of its track record setting up similar systems in other states, Daly said.

The contract to pay for the software itself will appear before the council as a separate item in June.

Also Wednesday, the Executive Council voted unanimously to approve $1.4 billion in spending for the month of June, averting a state government shutdown. According to WMUR, the spending includes more than $900 million for COVID-19 relief programs proposed by Gov. Sununu.

This article is being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.