Search for vaccine exemption rates in Texas for your school or district

While the number of measles cases is at its highest level in 25 years in the United States, Texas medical experts fear that the state will be at the root of the next outbreak of an epidemic. preventable disease by vaccination. Texas has reported 15 cases of measles confirmed so far in 2019, six more than for the whole of 2018.

Health officials are keeping a close watch on Texas 'pockets because of the number of parents seeking an exemption under Texas' vast vaccine law. Texas is one of only 16 states that allow parents to bypass immunization requirements to enroll their children in school by claiming an exemption from conscience, as well as by citing concerns from parents. Medical or religious order. Last month, Washington put an end to conscientious exemptions in the wake of a major measles outbreak with more than 70 reported cases. Three states – California, West Virginia and Mississippi – only allow medical exemptions.

The Texas exemption law was previously stricter. In 2003, a state senator suggested easing restrictions by proposing a three-page amendment to a 311-page bill. After five minutes of discussion, the amendment was approved. The bill was soon signed. Sixteen years later, the former senator, Craig Estes, said the change in Texas laws on vaccines that he helped enact should be reviewed in the current public health climate.

"Obviously, we never imagined what would happen," Texas Prosper Republican Texas Estes said. "Given recent developments, I would encourage the legislature to revisit and debate this issue."

The speed with which the Texas legislature weakened state rules on vaccine exemption suggests that, like Estes, few people in power at the time thought this would expose Texas to future outbreaks. . However, while experts suggest that Texas is now vulnerable, efforts to amend the exemption law have been unsuccessful on arrival at the Capitol.

"There will be a terrible measles outbreak in Texas and children will be hospitalized in intensive care units, as in New York today," said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine. . , said last month. "This will wake up the state legislature so that it will realize that there is a problem and close these exemptions."

Exemption Tracking in Texas

Kindergarten children must have 10 vaccines to be enrolled in Texas schools. Since 2006, When the state began to release the data, the exemption rate for kindergarten children in Texas rose from 0.3% for the 2005-2006 school year to 2.15% for the 2018-2019 school year.

In Texas, school districts, private schools and charter schools are required to report their vaccine exemption rates by vaccine. Data collection is done through a survey conducted by Texas State Department Health Services, but some schools do not report consistently, leaving gaps in the data.

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The data shows that some communities – such as the Dallas Independent School District – have recently experienced a dramatic rise in the number of kindergarten children's conscience exemptions. Others, like El Paso ISD, have seen the exemptions collapse recently. At the same time, some small private schools have significantly higher exemption rates than other schools. The Austin Waldorf School had the highest vaccine exemption rate for the 2018-19 school year, with 52.9%. The Alliance Christian Academy had the second highest rate with 40.6%.

When a sufficient community is immune to an illness, this group has what is called collective immunity, which means that the risk of spreading the disease is low. Vaccine-preventable diseases have different immunity thresholds. Measles, which is highly contagious, has a high immunity threshold of 95%. According to a state report for the 2018-2019 school year, coverage levels greater than 95% for kindergarten children in Texas were available for all required vaccines. Yet data from school districts and private schools suggest that some communities may not reach this threshold for some vaccines.

A five-minute discussion

Prior to 2003, the state's education code gave parents two options to exempt their children from vaccines: submit a medical waiver form signed by a doctor or sign an affidavit stating that the ############################################################################## The administration of a certain vaccine was in contradiction with "the principles and practice of a recognized church or religion". denomination. "

State legislators voted this year to significantly expand the number of people eligible for non-medical exemptions when they approved House Bill 2292, a 311-page bill that reorganized the vast network of intellectual property rights. 39; state health and social service organizations by grouping 12 state agencies out of 5, allowing the state to save $ 1 billion. The bill was a high priority as lawmakers strove to fill a $ 10 billion shortfall, said former Republic representative Talmadge Heflin, one of the co-sponsors of the draft bill. law.

The Estes Vaccine Amendment removed language restricting religious exemptions to vaccines violating the principles of a "recognized church or religious denomination." He replaced this with the more vague "religious belief" and added a new exemption category: "reasons of conscience". The amendment also lowered the bar for medical exemptions, allowing a doctor to sign up when he thought the vaccine would "pose a significant risk" instead of the previous requirement that the vaccine "would cause harm "to a child.

When Estes introduced the Senate amendment in 2003, he offered to offer an option to parents wishing to opt out of a vaccine for non-medical reasons, for example if a brother or sister had an "undesirable effect". He did not mention the broadening of religious language nor explained the reasoning behind the addition of "reasons of conscience" to the status of the state. He praised a provision forcing the state to give parents who requested an exemption from conscience an additional document warning them of the potential health risks of not vaccinating their children.

"What I like the most about this amendment is the fact that we make sure that the affidavit they fill out with the health ministry explains the consequences of not vaccinating their children. I hope that this will help to better understand It is important to get vaccinated, "said Estes to his fellow senators.

The amendment of Estes has not come out of blue. Dawn Richardson, Director of Advocacy at the National Vaccine Information Center, was among those who pushed Texas to adopt a conscientious exemption system in 2003. She said the conversation on this issue had started at the beginning. the 1997 session, but that there had been no significant movement until 2001. A draft law relaxing the exemption system adopted by a committee of the House but failing to in the assembly for a vote in front of the whole House. Nevertheless, the issue had not been thoroughly debated in Parliament and the Senate.

"It's a seven-year process in which many bills have been tabled," said Richardson. "Like many bills to change this type of situation, it sometimes takes several sessions to work with different lawmakers to get things done."

The success of Estes amendment in the Senate has been shaped in part by the discussion about vaccines at the time.

Three years earlier, in 2000, measles had been declared eliminated in the United States. Seth Mnookin, director of the Scientific Writing Program at the Massachusetts Institute of Technology and author of "The Panic Virus: The Real Story Behind the Vaccine-Autism Controversy," said the statement was a medical step that could have inadvertently reduced fears of seeing other people contract the disease in the future.

"Even for advocates of vaccines, who were very concerned about the possibility of measles outbreaks and knew how dangerous measles was, even with that, there was this feeling that worry was almost fictitious "said Mnookin. "In some ways, what we've seen over there – and we're seeing it again and again with vaccines – is that the vaccines have fallen victim to their own success."

Former Senator Leticia van de Putte said she was working with Estes to refine the wording of the amendment, which she described as "somewhat vague" at her first reading.

Van de Putte, a Democrat from San Antonio, recalled that vaccines raised concerns at the time, partly related to thimerosal. The preservative, which contains small traces of mercury, was commonly used in multi-dose vaccines to prevent cross-contamination. In 1999, a review of the Food and Drug Administration revealed that there was no evidence that mercury was causing a harmful effect, but that in some cases the amount could be greater than the exposure mercury recommended by the World Health Organization. In 2001, vaccine manufacturers eliminated thimerosal from all US vaccines recommended for children under 6, with the exception of the influenza vaccine.

Conflicting warnings about thimerosal have raised concerns that vaccines are unsafe.

"That's what we really looked at the time," Van de Putte said. "Now, if you look at the data since then, we know that's not the case."

In parallel with the controversy over thimerosal, a now discredited study linking MMR (measles, mumps and rubella) to autism also raised concerns at the time, said Rekha Lakshmanan, director of advocacy for The Immunization Partnership, a non-profit association for immunization. Lakshmanan pointed to the 1998 study of Andrew Wakefield, a British gastroenterologist who lost his medical license in 2010 and now lives in Austin, as a pivot source of the anti-vaccine movement today.

Once Texas' less restrictive vaccine exemption system came into effect on September 1, 2003, public health experts became concerned about the number of parents who would benefit from the new exemption for conscience option.

"We do not know who to expect," said Doug McBride, spokesman for the state's health department. Fort Worth Star-Telegram in 2003. "From the point of view of the protection of public health, we hope that it will not be very numerous, but that it is a legal option. parents to base their requests for exemptions on specific information. "

State data suggest that, for the last 16 years that Texas has relaxed its exemption system, the number of families who have benefited from it has increased dramatically. The state tracks the number of affidavit requests it receives each year – although some forms are never submitted. During the 2004 fiscal year, Texas received affidavit requests for vaccine waiver dispensation on behalf of 7,250 individuals. By 2018, this number had increased more than tenfold to 76,665 people.

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A new Anti-vaccine movement

After 2003, the next turning point in the anti-vaccine movement in Texas came 12 years later.

"There has always been a very small minority group who have voiced their voices and opposed vaccines," Lakshmanan said. "But in 2015, things changed and there was a new iteration of deniers and anti-vaccine advocates."

This year, While outbreaks of measles and whooping cough began to appear in pockets in Texas and other parts of the country, state representative Jason Villalba tabled a bill in the US. hope to remove the option of waiving the conscience of the state law. The House 2006 bill aimed to limit vaccine exemptions to a "determined and verifiable religious reason," according to the text of the bill. Villalba said that it was an attempt to protect children from vaccine-preventable diseases.

"We're just saying," Look, if you want to send your children to public schools, they have to be vaccinated, "said Villalba, a Dallas Republican, in 2015.

Response to Villalba's bill marked a change in the language of vaccine criticism of "anti-vaccine" to emphasize "choice of vaccine "and" medical freedom ".

Jackie Schlegel, who lives near Austin, said she had heard about the Villalba bill and that other mothers had organized a rally on Capitol Hill to oppose it. Texans for Vaccine Choice was born and the band has been active on the Capitol since.

"Texas has a long tradition of valuing parental rights, and that's what it's all about for us," group chairman Schlegel told dozens of Texas Capitol supporters in May. . At his side, Robert F. Kennedy Jr., one of the country's most prominent vaccine critics, went to Austin for the event.

Since the 2015 session, Texans for Vaccine Choice has argued against changes to the State Exemption Act and efforts to increase access to vaccine exemption data.

When Senator Kel Seliger, R-Amarillo, introduced legislation this year that would have allowed the public to obtain vaccine exemption rates by school rather than by school district, several members of Texans for Vaccine Choice testified against. They said that this would lead to an increase in bullying and the distinction between children enjoying an exemption. Seliger's bill, like all the other vaccine bills tabled this year, went nowhere.

Hotez, one of the country's leading advocates for the vaccine, found himself a target of defenders of the current Texas system while he urged lawmakers to consider certain vaccine-related bills during this session. In an animated Twitter exchange between Hotez and state representative, Jonathan Stickland, Republican of Bedford called vaccines "witchcraft to consumers." However, in an interview with The Dallas Morning NewsStickland said he was vaccinating his children but was supporting parents' right to choose if and when to vaccinate their children.

Hotez warned that a measles outbreak could hit the state to amend the law on exemptions, as did the measles outbreak at Disneyland in 2015 led California to pass a law reinforcing its Vaccine exemption system to allow only medical exemptions.

Texas has notified 15 confirmed cases of measles this year up to May, the highest number of measles cases seen since 2013. However, no outbreaks have been confirmed – defined as three or more related cases – this year so far. Despite the lack of outbreaks in the state, said Hotez, the current state vaccine immunization system will continue to pose a risk to public health. .

"Texas has so far escaped a terrible measles outbreak like New York," said Hotez. "But it's only a matter of time."

Disclosure: Baylor University financially supports The Texas Tribune, a non-partisan, non-profit news organization funded in part by donations from members, foundations and sponsors. Financial supporters play no role in Tribune journalism. Find a complete list here.