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Ohio’s immunization laws could undergo a significant shift.
This change would occur if House Bill 561, commonly referred to as the Ohio Hepatitis B exemption (Hep B exemption) bill, also known as the Parental Clarity on Health Options and Information on Conscientious Exemptions (C.H.O.I.C.E.) The Act advances through the legislature.
The bill proposes a Hep B exemption by removing the Hepatitis B (Hep B) vaccine requirement for children enrolled in licensed childcare centers, Head Start programs, and preschools. While supporters frame the bill as a win for parental rights and clarity, public health leaders warn that it could weaken disease prevention safeguards.
HB 561 is now in the Ohio House Health Committee, where it awaits further hearings. The proposal is already driving debate across the state, including in Cincinnati. Local healthcare providers and parents are tracking the potential impact on childcare settings.
What House Bill 561 would change
HB 561 was introduced by Rep. Melanie Miller (R-Ashland) and Rep. Monica Robb Blasdel (R-New Waterford). The legislators say their goal is to simplify state vaccination rules, strengthen existing exemption rights, and ensure parents understand their legal options.
The bill would make four major changes:
Hep B exemption from required childcare immunizations
Currently, children in licensed childcare must have documentation showing they have been vaccinated, are in the process of vaccination, or have a valid exemption. HB 561 would drop Hep B from that list. This means childcare centers and preschools could no longer require it as a condition of enrollment.
Prevent centers from creating custom exemption forms
Schools and childcare providers sometimes request additional documentation beyond what state law requires. HB 561 would restrict them from asking for extra forms, physician letters, or other materials not explicitly required under Ohio law.
Limit exclusion of exempt children during outbreaks
Under the bill, schools and childcare centers would not be allowed to exclude healthy children with valid medical, religious, or conscientious exemptions. This prohibition applies even during a disease outbreak. Supporters argue this protects children from “unnecessary discrimination,” but medical professionals say the rule could hinder outbreak control.
Require clearer communication about exemptions
The bill mandates that schools and childcare providers give parents transparent, standardized information about their legal right to request medical, religious, or conscientious exemptions.
The Parental C.H.O.I.C.E. Act reflects the sponsors’ focus on parental authority.
How Ohio currently handles childcare immunizations
Under Ohio Revised Code 5104.014, licensed childcare programs must maintain a “medical statement of immunization” for each enrolled child. This record includes:
- Vaccination dates
- Whether the child is “in process” of receiving the required doses
- Whether the child is exempt
- The type of exemption: medical, religious, or philosophical (conscientious)
Parents already have broad rights to exemptions under state law. However, public-health officials say the vaccination records themselves, including which children are exempt, are crucial. These records are important for quickly assessing risk during outbreaks.
HB 561 would limit the additional documentation that childcare settings can request, and it would prohibit excluding exempt children during certain infectious-disease events.
Critics say this could create confusion about which students are vaccinated and complicate containment.
Public-health community sounds alarm with Hep B exemption
Reports from the Ohio Capital Journal say that many Ohio pediatricians, infectious-disease specialists, and childcare-health advocates oppose HB 561.
Their concerns aren’t limited to Hep B. They say the bill would set a precedent that weakens the state’s overall immunization infrastructure.
Melissa Wervey Gittelman, CEO of the Ohio Chapter of the American Academy of Pediatrics, has been one of the bill’s most vocal critics. She warns that Hep B exemption from required immunizations makes a vulnerable age group—infants and toddlers—more susceptible to infection.
Hepatitis B is a viral infection that can cause chronic liver disease. Many people infected as infants remain lifelong carriers.
Gittelman argues that:
- Removing the requirement could lower vaccination rates in childcare settings.
- Restricting the exclusion of unvaccinated children during outbreaks reduces a key public-health response tool.
- Reducing documentation requirements may blur which children are or are not protected.
Citing past outbreaks as warnings
Health advocates point to Ohio’s recent measles outbreak in New Albany. During the outbreak, unvaccinated or documentation-uncertain students were excluded from school for 21 days, a standard containment measure.
They argue that HB 561 would prevent schools from taking similar steps, prolonging or worsening outbreaks.
Public-health experts note that while Hep B does not spread like measles, the weakened enforcement mechanisms could affect other diseases in the future.
Supporters emphasize parental rights and oversight
Sponsors of HB 561 argue that the bill strengthens parents’ confidence in their decision-making. Rep. Blasdel says the legislation ensures parents “never face confusion about the exemption process.”
Supporters also stress the following:
- HB 561 does not eliminate all vaccination requirements. It applies only to Hep B for childcare programs.
- Schools cannot require extra paperwork beyond what the statute allows.
- Advocates say some districts have created unnecessary hurdles.
- Parents retain existing responsibilities for medical decision-making.
They argue that state law should not punish families with legitimate exemptions.
Supporters also say the term “removing Hep B requirement” has been misunderstood.
They note that parents may still choose the vaccine, and many providers will continue recommending it.
Implications for Cincinnati childcare centers
Cincinnati-area childcare providers, especially those serving infants under age two, are watching HB 561 closely. The bill could change how centers manage:
- enrollment policies
- immunization tracking
- outbreak procedures
- communication with families
Local pediatricians say that even if Hep B is removed as a requirement, the vaccine will still be recommended. But they worry childcare centers may lose the ability to request information needed to keep classrooms safe, particularly during disease exposure events.
Some Cincinnati childcare operators say they support parental choice but fear losing tools that help protect immunocompromised children.
What happens next
The Ohio House Health Committee now holds HB 561 for review. Lawmakers there will hear testimony from parents, physicians, childcare providers, and public-health officials. After committee review, it could move to a House vote before heading to the Senate.
If passed, HB 561 would significantly reshape Ohio’s childcare immunization policies—reducing requirements, strengthening exemptions, and altering outbreak-response practices.
Public-health organizations and parent groups across Cincinnati and the state say they’ll continue to monitor the bill’s progress. They call it one of the most consequential vaccination-policy debates Ohio has seen in years.
/with reports from Ohio Capital Journal
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