law takes effect Sept. 1 and requires licensed child care facilities to create a vaccination policy for their employees. Dr. Terk says the law is modeled after the health care worker vaccination bill passed in the 2011 session. (See “Life- saving Shots,” August 2012 Texas Medi- cine, pages 25–29.)
He explained to the House Public Health Committee in April that SB 64 does not dictate what must be included in each facility’s policy. “We want to be sure each facility has the freedom to make the decision on how best to balance the safety and health of its employees and the children in their care with the cost associated with certain vaccinations,” he said. Representative Zerwas, an anesthesi- ologist, says he didn’t hesitate to spon- sor SB 64 because immunizing child care workers is a crucial step in preventing the spread of disease and improving the population’s health. “Immunization policy is really easy to get behind because it’s just good public health policy. Anything we can do to fa- cilitate the use of vaccines is in every- one’s interest,” he said. Dr. Zerwas is pleased many immuni- zation policies supported by TMA, TPHC, and other health organizations passed this session. “I’m not sure why so many of these
bills had traction this year. It may be that legislators have become more aware of the sound scientific evidence surrounding immunizations in terms of public health policy,” he said. Physicians received some tax sup-
port in regard to immunizations, as well. Rolled into an omnibus franchise tax bill, House Bill 500, is relief that will help primary care physicians provide vaccina- tions by allowing them to deduct from their taxable revenues the cost of pur- chasing and stocking vaccines. The busi- ness franchise tax levies a 1-percent tax on vaccine payments that Dr. Terk says “erodes an already thin margin on the economics of providing vaccines for phy- sicians in private practice” and “threat- ens the infrastructure that supports vac- cination for the majority of children and adults in the state.”
TMA headed back to the Capitol this
session to address meningococcal vac- cine requirements for college students and succeeded in advocating passage of Senate Bill 62, designed to target immu- nization at those with the greatest risk of disease and reduce the volume of stu- dents seeking conscientious exemptions. In 2011, the legislature passed Senate Bill 1107, which required entering col- lege students up to age 29 to be vacci- nated against bacterial meningitis. Donald Murphey, MD, medical direc- tor of infectious disease at Cook Chil- dren’s Health Care System in Fort Worth, testified on behalf of TMA and the Texas Pediatric Society (TPS) for SB 62 by Sen- ator Nelson and Rep. Jodie Laubenberg (R-Parker). He explained to the Senate Higher Education Committee that the 2011 law created numerous challenges for young adults seeking college admis- sion. He says many college students don’t have a primary care physician or health insurance and have difficulty get- ting vaccinated. “Colleges have also faced challenges in implementing this legislation. We want students vaccinated against bacte- rial meningitis. We don’t want this vac- cination requirement to become a bar- rier for a student enrolling in school,” he told the committee. Dr. Murphey says the new law, which
takes effect Jan. 1, 2014, helps address some of the challenges SB 1107 created by aligning the targeted immunization population more closely with Centers for Disease Control and Prevention (CDC) meningococcal vaccine recom- mendations. CDC’s Advisory Commit- tee on Immunization Practices (ACIP) recommends routine meningococcal vaccination of children aged 11 through 12 years and one-time booster doses be- tween ages 16 and 18, depending on the child’s age at the time of initial vaccina- tion. Visit
www.cdc.gov/vaccines/pubs/ ACIP-list.htm#mening for ACIP’s menin- gococcal vaccine recommendations. SB 62 requires vaccination of stu- dents aged 21 and younger and estab- lishes a DSHS online exemption form, which Dr. Murphey says represents “a reasonable compromise for students seeking an exemption.”
He adds that the department’s online
exemption portal features educational information on bacterial meningitis and the vaccine. Despite strong support from TMA and other health organizations, not all of the coalition-backed immunization bills made it to the governor’s desk. House Bill 772 by Rep. Donna Howard (D-Aus- tin), regarding the consent process for ImmTrac, the state’s immunization reg- istry, passed in the House, but the Sen- ate Committee on Health and Human Services did not consider it. Passage of the bill would have changed the consent process for ImmTrac to opt out rather than opt in.
House Bill 771 by Representative
Howard would have allowed patients to consent to their vaccination records remaining in ImmTrac until they reach age 26. The bill remained in the House Committee on Public Health. ImmTrac currently stores vaccination records un- til a person’s 18th birthday and gives the person a year to consent to having the records stored there. TMA and TPHC supported the legislation because it would help prevent immunization data from being expunged, as many 18-year- olds don’t know about the ImmTrac con- sent period.
Legislation up in smoke Once again, lawmakers failed to pass a comprehensive smoke-free indoor work- place policy. TMA backed House Bill 400 by Rep. Myra Crownover (R-Denton) and Senate Bill 86 by Sen. Rodney El- lis (D-Houston) to prohibit smoking in workplaces.
All articles in Texas Medicine that mention Texas Medical Association’s stance on state legislation are defined as “legislative advertising,” according to Texas Govt. Code Ann. §305.027. That law requires disclosure of the name and address of the person who contracts with the printer to publish the legislative advertising in Texas Medicine: Louis J. Goodman, PhD, Executive Vice President, TMA, 401 W. 15th St., Austin, TX 78701.
August 2013 TEXAS MEDICINE 43
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