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U.S. Vaccine Exemptions Remain Secure in 2018

Posted: 9/12/2018 12:36:55 PM | with 5 comments


NVIC’s 2018 Annual Report on U.S. State Vaccine Legislation: Breakdown, Trends and Predictions

By NVIC Advocacy Team

Protection of the human right to exercise informed consent to vaccination continues to be a topic that is of great concern for many people in America. In a 2018 Annual Report on U.S. State Vaccine Legislation, the non-profit charity National Vaccine Information Center (NVIC) reports that during this year’s legislative session, no state eliminated or restricted existing medical, religious and conscientious or philosophical exemptions for daycare or school attendance.

This is the third year in a row that state legislatures have rejected the efforts of vaccine industry lobbyists to persuade more state governments to do what California did in 2015 and eliminate the legal right of citizens to exercise freedom of thought, conscience and informed consent when making vaccine decisions for themselves and their children.

Working to prevent vaccine injuries and deaths through public education since 1982, NVIC is the largest and oldest U.S. charity disseminating information about diseases, vaccines and informed consent to vaccination. NVIC provides well-referenced, accurate information to the public about vaccination and health but does not make vaccine use recommendations. In 2010, NVIC launched the NVIC Advocacy Portal (NVICAP), a free online vaccine choice advocacy network, for the purpose of securing and defending informed consent protections in state vaccine policies and laws.

nvicap banner

NVIC works alongside and shares legislative information with many health freedom groups that support NVIC’s more than three-decade call for the protection of vaccine informed consent rights in America. The NVIC Advocacy Portal team, including key NVIC Advocacy directors in many states, works with families and enlightened health care professionals to educate legislators and protect vaccine informed consent rights.

During the 2018 legislative session, NVIC analyzed, tracked and issued positions on 143 vaccine related bills in 36 states through the NVICAP.1

If you live in one of the following 36 states, your state had one or more of the 143 vaccine bills being considered in the 2018 legislative session and tracked by NVIC: Alabama, Arizona, California, Connecticut, Delaware, Florida, Georgia, Hawaii, Iowa, Idaho, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Maryland, Maine, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Virginia, Vermont, Washington, Wisconsin, and West Virginia.

Bills referenced in this report are published on the NVICAP and registered users can obtain a more detailed bill analysis, including current status, NVIC’s position on the bill, and recommended action.

Highlights from 2018

There were three significant positive take away points from the outcome of the 2018 legislative session:

  • No state lost or restricted existing vaccine exemptions for school, daycare, or other statewide requirements;
  • Out of the 82 vaccine-related bills that NVIC opposed, only 17 bills passed. Out of the 17 bills that did pass, only four bills had elements that NVIC targeted for strong opposition; and
  • The 2018 legislative session featured more proposed vaccine-related bills worthy of support (47) than any session since the launching of NVIC’s Advocacy Portal in 2010.

There were three states with 10 or more bills filed this session. Oklahoma set the record with 13 bills, but they all died. Minnesota had 10 bills filed that all died.  New York also had 10 bills filed and only one bad bill passed (A 9507), which allows pharmacists to give flu shots to young children two years and older and compels pharmacists administering vaccines to children to not only report and track the shots they administer, but to track vaccine refusals as well. 

The three other bills passed that NVIC strongly opposed: a meningitis vaccine mandate in Louisiana (HB 176) and Maine (LD 1664), and a bill in Alabama (HB 76), which requires religiously-affiliated private daycares and preschools to give the Department of Human Services vaccine records on request.  The remaining 13 bills that NVIC opposed fall into the category of Required Vaccine Marketing and Promotion.

The vaccine-related bills that either passed or were defeated in states during the 2018 legislative session are broken out and described below by category.

2018 Bill Analysis by Category

The four main areas that NVIC focuses on when tracking proposed bills are: (1) vaccine exemptions and informed consent rights; (2) vaccine mandates; (3) vaccine tracking and reporting and (4) vaccines in general.  Some bills may be included in multiple categories. For example, a proposed bill attempting to mandate a vaccine may also have a requirement for vaccine tracking so it would be counted in both categories but only counted once in the total bill count.

The breakout and analysis of bills in these different categories identifies trends across the states and serves as a guide if you want to become active by joining the NVIC Advocacy Portal (NVICAP) and educating your state legislators and community in 2019 about why it is so important to protect vaccine informed consent rights.

Vaccine Exemptions and Informed Consent (61 bills)

The majority of the 61 vaccine-related bills filed in state legislatures in 2018 had components that affected vaccine exemptions and informed consent rights. NVIC opposed 20 of the proposed bills, supported 37, and “watched” four of them.  This is a huge improvement from 2017, when NVIC tracked 81 bills, opposed 42 and supported 39 bills.  This shift can be directly credited to positive action taken by forward thinking state legislators, who were given fact based information about vaccination and diseases by concerned citizens who took the time to make one-on-one personal contact with their elected representatives.

The NVIC Advocacy team provides referenced, accurate vaccine information and talking points for NVICAP users to background legislators. Some of the position statements NVIC posted on the Advocacy Portal in 2018 were listed as bills to “watch” because our analysis indicated they contained sections that could be vulnerable to amendments that would conflict with NVIC’s mission.

statue of liberty

Eliminating or Restricting Vaccine Exemptions

Vaccine choice advocates successfully held the line on protecting vaccine exemptions in 2018 and no state legislature repealed or restricted existing school, daycare or statewide vaccine exemptions.

Only three bills and one resolution spanning two states proposed to eliminate vaccine exemptions, and these attempts failed. In Minnesota, two bills that tried to eliminate conscientious vaccine exemptions (SF 3977 and HF 4406) failed to secure even a single hearing. The same thing happened in Oklahoma, where a bill (SB 1123) that would have eliminated all exemptions to vaccination except for limited medical reasons, along with a resolution (SJR 57), which would have placed the elimination of all non-medical exemptions on the next general election ballot, were both rejected.   

Minnesota HF 96 and SF 143 would have required parents to get a physician to sign off on the conscientious belief exemption and would have replaced the language “conscientious belief” with “personal belief,” but both of these bills died. Government health officials do not like vaccine exemption language that includes the words “religious” or “conscientious” because freedom of religion and freedom of conscience are defined as human rights. 

At the time this report was written (September 8, 2018), there were two bills still pending in Ohio and New Jersey that would restrict vaccine exemptions. A bill in Ohio (HB 559) proposed to mandate that parents use a state form to file a vaccine exemption for their child, which requires the signature of a health care provider, and two bills in New Jersey (A 3818 and S 2173) proposed to restrict religious belief exemptions to vaccination. New Jersey families supporting the legal right to take a religious vaccine exemption will need to watch these bills closely and be ready to immediately take action to oppose them in order to protect that right. NVICAP is watching those bills and will post new information on the status of those bills as it becomes available.

It is critical that vaccine choice advocates residing in states, which currently have philosophical or conscientious vaccine exemptions, be aware that NVIC predicts there will be renewed unjustified attacks on those exemptions by the vaccine industry and medical trade associations next year. Now is the time to educate your legislators through the end of this year and early next year so you can be ready to counter bills that will restrict or eliminate those exemptions. Recently, certain states have been heavily targeted for criticism by the mainstream media and forced vaccination proponents for allowing philosophical or conscientious vaccine exemptions, including Arkansas, Arizona, Idaho, Maine, Minnesota, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Texas and Utah.2  

Exemption Disclosure and School Shaming

One way vaccine industry lobbyists place disruptive pressure on schools allowing students to enroll with vaccine exemptions is to lobby for legislation that requires individual schools to publish vaccine exemption rates and post that information online.  These bills are promoted under the guise of educating parents, but they are really about government-sponsored shaming that pits school against school and parent against parent for the purpose of marginalizing and increasing peer pressure on families whose children have vaccine exemptions.

Fortunately, there were only three school shaming bills filed this session with two in New York (A 3912 and S 2955) and one in Arizona (SB 1358), and none of these passed.  This is a big improvement compared to the 11 school shaming bills filed in 2017. 

Children Vaccinating Themselves?

A very troubling area of proposed legislative changes are bills that allow minor children to be vaccinated without the knowledge or informed consent of their parents.  A child is less likely than an adult parent to understand their personal and family medical history, including a history of vaccine reactions, allergies and autoimmune or neurological disorders. Minor children do not have the same kind of critical thinking skills or emotional maturity required to make a vaccine benefit-risk decision compared to an adult. In addition, if a child receives a vaccination without a parent’s knowledge or informed consent and experiences a vaccine reaction, a parent might not recognize the potential cause of their child’s sudden decline in health. This lack of knowledge by parents could be life threatening for the child.  

The Minnesota legislature saw four bills introduced that would have allowed minor children to consent to HPV vaccinations without their parents’ knowledge or approval  and none of them even garnered enough support among legislators to schedule a hearing. A child vaccine consent bill, which covered the HPV vaccine and vaccines for other sexually transmitted diseases, was introduced in Connecticut but failed to move out of committee. New Hampshire went even further with another unsuccessful child consent bill that proposed granting permission to minor teens aged 16 and older to agree to all medical procedures, including for vaccinations, without parental knowledge or consent.

Expanding Vaccine Exemptions and Informed Consent

Hard working vaccine and health freedom advocates and open minded legislators came together to introduce 16 bills filed in eight states to expand vaccine exemptions and protect informed consent rights. 

Legislators in Hawaii, Mississippi, Rhode Island and West Virginia introduced bills to add philosophical or conscientious belief exemptions.  Mississippi and West Virginia legislators proposed bills to add religious exemptions to vaccine laws that currently only allow a narrow medical exemption, while New York considered a bill to streamline and simplify the obtaining of a religious exemption.   None of these bills passed this session.

Regarding adult employees, Illinois successfully passed a religious exemption (HB 2984) for annual flu vaccination requirements for health care workers.  Minnesota, Mississippi, Oklahoma, and West Virginia had bills filed adding exemptions for other adult employees, but none of them passed.

Expanding vaccine informed consent rights is an area that 10 states took on during 2018.  Although none of these bills passed (Pennsylvania is still pending), bills to obtain informed consent prior to vaccination were introduced in Hawaii, Minnesota, Oklahoma, and Rhode Island, and bills that would require disclosure of vaccine exemptions were introduced in Indiana and Pennsylvania. These are examples of bills protecting informed consent rights that more legislators have been receptive to filing in state legislatures.

Oklahoma broke important ground this session taking a stand for parental rights. A bill was filed (SB 1432) to remove the ability of the Department of Human Services to vaccinate children in protective custody and another bill (SB 1433) was filed to clarify that refusing to vaccinate or delaying vaccination is not child abuse.  While these bills did not pass, reigning in state child protective services offices attempting to criminalize voluntary vaccine decision making and override parental rights is another area state legislators have expressed an interested in addressing with proactive legislation.

Since the American Academy of Pediatrics (AAP) came out squarely against conscientious and religious vaccine exemptions in 2016, 3 more families have experienced their children being “fired” from pediatric practices if parents decline to give their children every one of the 69 doses of 16 federally recommended vaccines on a vaccine schedule endorsed by the CDC and AAP. 4  In two states, legislators introduced bills that addressed this kind of physician discrimination and withholding of medical care from different perspectives, although neither of the bills passed.  In Missouri, a bill (HB 1560) was proposed to prohibit discrimination against children by preventing doctors from expelling patients based on vaccination status. In Oklahoma, a bill (HB 3444) was introduced prohibiting health insurance companies from (1) requiring the administration vaccines; (2) penalizing doctors for not administering vaccines, or (3) providing financial incentives to physicians to issue a vaccination protocol.

Threats and outright denial of healthcare by physicians based on a patient’s vaccination status is a growing problem in America and a number of state legislators are justifiably concerned about it and have become more open to considering bills to prohibit such abusive practices.  NVIC encourages families to educate their legislators about harassment and discriminatory practices by physicians and to share personal experiences related to threats and sanctions by physicians – or anyone else - for exercising vaccine informed consent rights by posting on NVIC’s Cry For Vaccine Freedom Wall.

Vaccine Mandates (30 bills)

In 2018, out of 19 bills that proposed to expand and add new vaccine mandates, only bills adding a meningitis vaccine mandate for 11th graders attending school in Louisiana (HB 176) and a legislative rule review bill (LD 1664) approving a health department rule requiring meningitis vaccinations in Maine for 7th and 12th grade students were passed. Bills to mandate meningitis vaccinations for school students failed in Kansas, Oregon and Virginia.

An HPV vaccine mandate in Florida (HB 1343 and SB 1558) was defeated after significant vocal opposition. Hawaii, Missouri, and West Virginia all failed to pass bills mandating more vaccines for various health care workers.

In Arizona, a bill (SB 1383) attempting to repeal the legal protection clarifying that foster parents are not required to vaccinate their natural or adoptive children as a condition of foster home licensure was defeated.  This was the same as SB 1268 from 2017 that failed to move forward as well.  We are grateful that Arizona legislators have consistently upheld the rights of parents to make informed vaccination decisions for their own children while they are helping to provide temporary homes for foster children.

New Jersey has bills (A 3587 and S 634) still pending that would mandate more vaccines for healthcare workers and healthcare vendors (A 2397), as well as mandate meningitis vaccinations for college students (A 1991 and S 941), and HPV vaccinations for students 6th through 12th grade (A 1847).  NVIC opposes all of these bills and will continue to post information about their movement on the NVICAP.   

NVIC supported seven bills in five states that would have restricted vaccine mandates.  Bills were introduced in Missouri, Mississippi and New Hampshire to eliminate Hepatitis B vaccine mandates but none passed.  Bills in both Michigan (HB 5162 and HB 5163) and Oklahoma (HB 2623) sought to return the power to add new vaccines to the mandated schedule back to a vote by the legislature instead of continuing to allow state health department officials to add new vaccine mandates through an administrative rule making process. The Oklahoma bill died, and Michigan HB 5162 and HB 5163 have not seen action since hearings at the end of 2017.

Vaccine Tracking and Reporting (22 bills)

Forced inclusion and OPT-OUT electronic vaccine tracking registries and enforcement systems continue to threaten the medical privacy of citizens and the legal right to delay or decline one or more federally recommended vaccines without harassment or punishment.  The 2018 legislative session included 22 bills in this category that NVICAP posted and tracked. This included six bills proposed in three states to expand government operated childhood vaccine tracking databases to also require the vaccination status of adults to be tracked.  

Florida, the third most populous state, saw multiple bills (CS/CS/HB 1045, CS/CS/HB 1047, and CS/CS/SB 1680) introduced proposing to legally require the vaccination status of every state resident to be stored and tracked in Florida’s government run electronic vaccine tracking registry for the purpose of reaching a 100% vaccine compliance rate by all children and adults. Requiring doctors to automatically upload the vaccine status of their patients into the state vaccine tracking system without securing their expressed OPT-IN informed consent of the person violates Section 23 of the Florida Constitution, which guarantees Florida residents the Right of Privacy: “Every natural person has the right to be let alone and free from governmental intrusion into the person’s private life except as otherwise provided herein.”  5 

Medical privacy and vaccine choice advocates worked together in Florida to educate legislators about the intrusive nature of these vaccine tracking bills.  Although none of these bills ultimately passed during the 2018 legislative session, Florida residents need to be ready next year during the 2019 session to continue to educate legislators about the importance of protecting medical privacy and vaccine informed consent rights in Florida.

In Kansas, a bill (HB 2121) was introduced that would have required all vaccines administered in the state to be entered into the state’s electronic vaccine tracking system. Two bills (H 7882 and S 2530A) introduced in Rhode Island would have expanded the state’s vaccine tracking registry to include all adults. NVIC opposed all of these bills because they didn’t require an adult’s OPT-IN written informed consent prior to being included in the vaccine tracking system. Fortunately, none of these bills passed.

Medical privacy and informed consent rights of Nebraska residents were protected when a resolution, which proposed to conduct an interim study on mandating the reporting of the vaccination status of all children and adults to the state’s electronic vaccine tracking registry, failed to pass. Pharmacists in Hawaii, who are already administering vaccines, were unsuccessfully targeted by a bill (HB 1950) that would have required them to report all vaccines given to the Hawaii Immunization Registry.

In Massachusetts, unsuccessful bills (H 3224 and S 1219) were introduced to expand the scope of the state’s vaccine tracking system to include vision screening and, in New York, bills (A3899A and S3941) proposed to make the blood lead levels of children already inappropriately stored in the vaccine registry available to schools. The stated purpose of the New York bills, which was to provide children with “appropriate educational services,” is a fallacy.  There is no blood test that can accurately determine a child’s educational needs.

The New York legislature did, however, pass a bill (A 9507) that not only authorizes pharmacists to give children as young as two years old annual flu shots, it mandates the reporting and recording of the administration of the vaccine as well as vaccine refusals to the state’s electronic vaccine tracking registry.  The passage of this bill will make it very difficult for families in New York City to enroll their children in daycare and preschool without annual influenza vaccinations. Just two months after the passage of A 9507, a 2013 rule invoked by the New York City Department of Health and Mental Hygiene requiring annual flu shots for preschoolers was upheld by the New York Court of Appeals. 6

In Vermont, a bill (H 247) was introduced and supported by NVIC that would have required the Department of Health to submit vaccine adverse reaction reports to the General Assembly. The bill did not pass.

Vaccines (37 bills)

Authorizing Pharmacists to Administer More Vaccines

More states continue to authorize pharmacists to expand services to include the administration of vaccines to younger and younger children.  In 2018, Missouri passed bills (SB 776 and SB 826) that now allow pharmacists to give all CDC recommended vaccines to children seven years and older, and New York passed a bill (A 9507) that now allows pharmacists to give influenza vaccinations to children as young as two years old.

Requiring Vaccine Promotion/Marketing

The overall single most active category in expansion of vaccine-related state legislation so far this year has been bills proposing to legally require the marketing and promotion of specific vaccines. Unlike legal requirements to be vaccinated, these mandates require either public or private businesses to advertise and promote vaccine use.

During this year’s legislative session, the vaccine to receive the most state-backed legislative support for active marketing and promotion by schools and medical and residential facilities has been influenza vaccine. This is the same under-performing vaccine that CDC officials themselves admit has one of the worst vaccine effectiveness outcomes on record: 36% effectiveness for the 2016/2017 flu season and ranging between a dismal 10% and 60% effectiveness over the last 14 years.7 

Perhaps the vaccine industry is trying to combat the well earned negative impression of the flu vaccine’s poor performance by lobbying for bills aimed at marketing and promoting use of the vaccine by children and adults. In 2018, bills were passed that now require daycare facilities in Alabama, schools in Illinois and Louisiana, and hospitals in Rhode Island, and long term and residential care facilities in Delaware and Indiana to promote annual influenza vaccinations. Similar bills to push flu vaccines in Florida, Massachusetts, Missouri, and Oklahoma all failed.

Fortunately Florida and Maryland legislators were smart enough to reject bills requiring schools to promote student use of the highly reactive HPV vaccine, 8 but a bill passed in Illinois that targets boys for HPV vaccine promotion programs. 

One of the more controversial attempts to market vaccines at taxpayer expense occurred in New York this year, when a bill proposing to grant a tax exemption for dependents fully vaccinated according to state health department recommendations was defeated.

A new legislative twist to save vaccine manufacturers from having to spend as much of their own money on advertising came up this legislative session when multiple resolutions targeting adults for shingles vaccination were passed in a number of states.  The CDC admits that shingles (herpes zoster) is increasing among adults in the United States.9 Some research suggests that the chickenpox (varicella zoster) vaccine licensed in 1995 and mandated in most states for children to attend school may have contributed to the increase in reported cases of shingles in older children and adults.10 This raises the question of whether the vaccine industry has been behind an orchestrated effort to get states to market shingles vaccine since so many resolutions were filed and passed in state legislatures in 2018.

The following 13 states filed resolutions to “encourage” shingles vaccinations or to declare certain months as shingles “awareness” or “improvement” months: Georgia, Illinois, Indiana, Louisiana, Michigan, Missouri, Nebraska, New Jersey, New Mexico, Pennsylvania, Rhode Island, Tennessee, and Wisconsin.  The only two states that did not pass a filed shingles vaccine resolution were Wisconsin and New Jersey (still in session at the time this report was prepared).  

Even Congress has jumped into the vaccine promotion resolution game to increase shingles vaccination uptake by adults.  A federal bill (HR 4297) known as the Protecting Seniors Through Immunization Act of 2017, was filed in November last year, but it hasn’t moved yet.

Three more vaccine promotion resolutions were filed and passed in California (SR 120), Kentucky (HR 278) and New York (AR 1403) aimed at increasing adult vaccination rates with all vaccines the CDC recommends for adults (seasonal influenza, Tdap, Td, shingles, HPV, pneumococcal).

While resolutions passed by state legislatures are different from bills that are passed because they don’t carry the force of law, these vaccine promotion resolutions still cost taxpayers money in terms of state resources devoted to the legislative process and for employees in state agencies to implement the resolution by creating ways to promote the message contained in the resolution.  These vaccine promotion messages tend to adopt a one-size-fits all approach and rarely do vaccine marketing materials contain information about vaccine risks or how to prevent vaccine injuries.

Comparing Recent Sessions to 2018

143 bills filed in state legislatures in 2018 represents a sharp decline in vaccine related legislation compared to the 184 bills filed in 2017; however it is still above the average of 135 bills filed per year when looking at the total number of state bills filed between 2014 and 2017 as reported in NVIC’s in depth analysis State Vaccine Legislation in America 2015-2017.  The number of states proposing bills that affected NVIC’s mission has declined as well since last year, from 42 to 36 states.

Some of the decline in numbers of vaccine-related bills filed can be attributed to four states: Montana, Nevada, North Dakota and Texas. These state legislatures meet biannually to consider new bills and do not hold a legislative session in even years. 11  In 2017, 26 of the 184 bills filed were in Montana (2), Nevada (1) and Texas (23).  If this trend continues, we should expect to see more vaccine-related bills introduced in 2019 than we have ever seen since the NVICAP was launched in 2010.

total bills

There were more positive bills filed in 2018 to expand vaccine informed consent rights, to restrict addition of new vaccine mandates and to restrict automatic inclusion of children and adults in electronic vaccine tracking systems than were introduced in 2017. There were also fewer bills that NVIC opposed this legislative session compared to 2017, such as bills proposing to eliminate or restrict vaccine exemptions, to increase vaccine tracking or to add new vaccines to school mandates, all of which had been steadily increasing before this year.

Enlightened legislators are not only listening to concerned constituents in greater numbers, they are resisting aggressive lobbying efforts by the vaccine industry to force the purchase and use of every vaccine produced by pharmaceutical companies and recommended by public health officials. 

nvicap supported

Slowly but surely as a result of many years of hard work, grassroots vaccine education and informed consent advocacy in the U.S. is achieving tangible results. It is a trend that the vaccine industry pushing for more oppressive forced vaccination legislation does not want to continue. It may help explain why there has been a recent increase in biased media articles 12 and newspaper OpEds 13 that minimize or deny very real vaccine risks 14 and attack vaccine exemptions, while marginalizing families and trying to delegitimize vaccine exemptions. 15

legislation trends

WHAT CAN YOU DO?

NVIC expects that the vaccine industry will step up lobbying efforts and that there will be many more vaccine-related bills filed in the states in 2019. Please become a registered user of the NVIC Advocacy Portal and check in often to learn about ways to personally educate your legislators when vaccine bills that affect your rights are moving in your state. Please encourage your family and all of your friends to do the same.

Clearly your efforts are making a much more significant difference than the media and those pushing “no exceptions” forced vaccination policies and laws are willing to admit, and your active participation is vital to protecting informed consent rights and vaccine choices in America. If you see inaccurate information in the media, please take the time to respond by making a constructive comment online. You can also email the journalist or call the media outlet and provide accurate, well referenced Diseases and Vaccines information and accurate state vaccine law information, which you can find on our website NVIC.org. NVIC’s updated, illustrated and fully referenced Guide to Reforming Vaccine Policy and Law is another good vaccine education tool for legislators and friends and family, too.

Yes, the challenges are great but so are the opportunities to educate and empower legislators and residents of every state to defend vaccine freedom of choice. NVIC is committed to continuing to make that happen and we look forward to working with you through the NVIC Advocacy Portal to help you protect vaccine informed consent rights in your state in 2019.

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Posted: 9/12/2018 12:36:55 PM | with 5 comments


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